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APPLICATION - LOT LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> PRQpO5EO PAtE�l..S <br /> Parcel Number Existing or Proposed Use of Parcel Existing Proposed <br /> Square Footage Square Footage <br /> /T <br /> or Acreage or Acreage <br /> 1) 7-- — 4�� �J 7SoU <br /> /x17 17 <br /> J <br /> Fill <br /> Public Water Service Provider Annex-Formation Distance to Public <br /> Existing Required Water(Feet) <br /> Proposed <br /> Private Water❑ Existing Well ❑ New Well ❑ Well Replacement ❑ <br /> .. Y .vi� $Iv^tl EYk�.:`'S'/E.MFF''3 4,v�; Y,1 j✓[RY � u=Y�; <br /> Public Sewage Service Provider Annex-Formation Distance to Publle <br /> Dispo al Required Sewer Facility <br /> Existing <br /> Proposed / /rr I� �d <br /> On-site Sewage Existing Septic System ❑ New Septic System ❑ Othel <br /> Disposal ❑ �//- <br /> SLorm Drainage <br /> Public Storm Service Provider Annex-Formation Terminal Drainage Detention- <br /> Drain a Required to: Retention Ponds <br /> Existin <br /> Prop ed CO <br /> Private Storm On-site Retention P nd(s) ❑ Natural Drainage/No Change ❑ Other ElDrainage❑ <br /> Dawe:@'ice Axa!t <br /> . �leotrtchy Re,�eR Na{uf#t Fx`as .: <br /> Service Provider Distance to Service Service Provider Distance to <br /> Service <br /> c _ U <br /> Telephone Service Cahie Tel;y�gpp gfylpgNo <br /> S ice Provider Distance to Service Service Provider Distance to <br /> Service <br /> i <br /> RP . <br /> y : <br /> Service Provider Distance to Bill Service Provider Distance to Fire <br /> C School Station <br /> �` >R'�.E'tiR1111p tlQiidt <br /> oad/Street Name R.O.W.Width Pavement Widt Curb/Gutter Sidewal s <br /> 1 <br /> 2 / Yes❑ No Yee❑ No <br /> Yes❑ No Yea❑ No <br /> Proposed kloeda <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> Yes❑ No❑ Yes ❑ No❑ <br /> Yea❑ No❑ Yes❑ No❑ <br /> .3- <br />