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,t4�IK. APPLICATION - LOT LINE ADJUSTMENT r` y, SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT FILE NUMBER: �4C%F pRH`P PROPOSED PARCELS Existing Square Proposed Square Parcel Number Existing or Proposed Use of Parcel Footage or Acreage Footage or Acreage 1 RESIDENTIAL 2.31 ACRES 2.31 ACRES 2 AGRICULTURAL/RESIDENTIAL 20.02 ACRES 20.02 ACRES SITE IMPROVEMENTS AND SERVICES Water Annex-Formation Distance to Public Public Water Service Provider R uired Water Feet Proposed ❑ Existin ❑ Private Water® Existing Well ❑ New Well ❑ Well Re lacement ❑ Sewage Disposal Public Sewage Ann tion Distance to Public Disposal Service Provider Re uired Sewer Facili Proposed ❑ Existin ❑ On-site Sewage Disposal ® Existing Septic System ® New Septic System ❑ Other ❑ Storm Drainage Public Storm Drainage Service Provider(if Public) Annex-Formation Terminal Drainage Detention-Retention Proposed ❑ Re uired to: Ponds Existing ❑ Private Storm Drainage® On-site Retention Ponds ❑ Natural Drainage/No Chane ® Other ❑ Electricity Telephone Service Distance to Service Provider Service Service Provider Distance to Service PG&E EXISTING AT&T EXISTING School Service Fire Protection Service Distance to Elem Service Provider School Service Provider =istance to Fire Station VICTOR ELEMENTARY 1.1 MILES LODI FIRE DEPT STATION NO.2 2.2 MILES Existing Roads Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks STATE HIGHWAY 12 ±69' 42' Yes❑ No® Yes❑ No Yes❑ No® Yes❑ No ZI Proposed Roads Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks NONE PROPOSED Yes❑ No ❑ Yes❑ No❑ Yes❑ No ❑ Yes❑ No❑ F:TEVSVC\Planning Application Forms\ Page 4 of 7 Lot Line Adjustment.doc.(Revised 6-4-04)