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<br /> }PLICATION - LOT LSE ADJUSTMENT
<br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT
<br /> :n. X
<br /> ` FILE NUMBER:
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<br /> Existing Square Proposed Square
<br /> Parcel Number
<br /> Existing or Proposed Use of Parcel Footacle or Acreage Footage or Acreage
<br /> 1 Agriculture with residence 2.20 ac gross
<br /> 2 Agriculture 7.80 ac
<br /> 3 Agriculture with residence 51.48 ac gross
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<br /> Annex-Formation Distance to Public
<br /> Public Water Service Provider Required Water Feet
<br /> Proposed ❑
<br /> Existing❑
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<br /> Private Water® Existing Well ® New Well ❑ Well Re lacement ❑
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<br /> Public Sewage Annex-Formation Distance to Public
<br /> Disposal Service Provider Re uired Sewer Facility
<br /> Proposed ❑
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<br /> On-site Sewage
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<br /> Disposal® __T Existing Septic S stem
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<br /> Drainage Service Provider(if Public) Annex-Formation Terminal Drainage Detention-Retention
<br /> Proposed ❑ Required to: Ponds
<br /> Existing❑
<br /> Private Storm
<br /> Drainage ® I On-site Retention Ponds ❑ Natural Drainage/No Chane ® Other ❑
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<br /> Distance to
<br /> Service Provider `' Service Service Provider Distance to Service
<br /> PG&E Existing SBC Existing
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<br /> i� Distance to Elem
<br /> Service Provider School Service Provider Distance to Fire Station
<br /> Escalon Unified ' 3 mi Ripon 2 mi
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<br /> ; ?s.. ��sti'.) :Roads
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<br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks
<br /> Wagner Road 40' 26' (estimate) Yes ❑ No® Yes❑ No
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<br /> Load/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks
<br /> N/A Yes❑ No❑ Yes❑ No ❑
<br /> Yes ❑ No❑ Yes ❑ No❑
<br /> F”DEVSVCIPlanning Application Formsl Page 2 of 3 Job No 2007-56 LLA.doc
<br /> Lot Line Adjustment.doc.(Revised 6-4-04)
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