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,! J <br /> � ,;•. APPLICATION -- LOT LINE ADJUSTMENT <br /> ESAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: <br /> NMI <br /> Existing Square~ Proposed Square <br /> Parcel Number Existing or Proposed Use of Parcel Foote a or Acrea a Foote a or Acrea e <br /> 226-160-04 One bilapidated SF House/Retail Commercial 0.25 ac 25.93 ac <br /> 226-1.60-0 Vacant / Retail-commercial 46.76 ac 21.07 ac <br /> I - <br /> Public Water Service Provider Annex-Formation Distance to Public <br /> Proposed❑ Required Water Feet <br /> Existin N/A at this time <br /> Private Water❑ Existin2 Well New Well ❑ Well Re lacement ❑ <br /> Public Sewage Annex-Formation Distance to Public <br /> Disposal Service Provider Required Sewer Facility <br /> Proposed❑ <br /> Existin N/A at this time <br /> On-site Sewage <br /> Disposal❑ Existing Se tic System ❑ New Se tic 5 stem ❑ Other ❑ <br /> Public Storm <br /> Drainage Service Provider(if Public) Annex-Formation Terminal Drainage Detention-Retention <br /> Proposed❑ Required to: Ponds <br /> Existing❑ N/A at this time' <br /> Private Storm <br /> Draina e❑ On-site Retention Ponds Natural Draina e1No Chane ❑ Other El <br /> Distance to <br /> Service Provider Service Service Provider Distance to Service <br /> N/A at this time N/A at this time <br /> - r <br /> Distance to EFem ! <br /> Service Provider School Service Provider Distance to Fire Station <br /> N/A at this time N/A at this time <br /> r <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> Union Road 25' 35' Yes❑ No Q Yes❑ No <br /> Yes❑ No❑ Yes❑ No❑ <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> N/A at this Yes❑ No❑ Yes❑ No❑ <br /> Yes❑ No❑ Yes❑ No❑ <br /> F:IDEVSVC1131anning Application Forms% Page 4 of 7 <br /> Lot Line Adjustment.doc.(Revised 6-4-04) <br />