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.(4oc APPLICATION — LOT LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: <br /> Existing Square Proposed Square <br /> Parcel Number Existin or Pro osed Use f Parcel Foota a or Acrea a Footage or Acreage <br /> Z A e 8. 0 — zlw�: <br /> 20 <br /> Annex-Formation Distance to Public <br /> Public Water Service Provider Re uired Water Feet <br /> Proposed❑ <br /> Existin k1a _ ell <br /> Private Water❑ Existin w Well lk� Now Well ❑ Well Re lacement,E <br /> iilllw 11. Will <br /> It,I=Nl"15 illill <br /> Annex-Formation Distance to Public <br /> Public Sewage <br /> Disposal Service Provider Re wired Sewer Facilitv <br /> Proposed El <br /> Existin 0 <br /> on-site Sewa e ❑ Other El <br /> Dis osal Existin Se tic stem N Se ti S tem <br /> p P!1! 0 <br /> Public Storm <br /> Annex-Formation Terminal Drainage Detention-Retention <br /> Drainage Service Provider(if Public) <br /> Re wired to: Ponds <br /> Proposed -1 <br /> Existing 71 <br /> Private Storm Natural Dain e/No Chane <br /> On-site n Ponds <br /> 1 al 9 <br /> Mui !I <br /> Distance to <br /> Se ice'! i, ovider Service Service Provider Distance to S rvice <br /> !stance to Elem Service Station <br /> Service ovider chool <br /> R 11��l <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> 0 6P e Yes❑ No Yes El No <br /> Yes❑ No❑ yes[] No El <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> 001 Yes L_j No❑ <br /> Yes E] No❑ Yes El No 0 <br /> Page 4 of 7 <br /> FADEVSVCpanning Application Forma, <br /> Lot Line Adjustmentdou (Revised 05-11-09) <br />