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Q� ..� APPLICATION - LOTS INE ADJUSTMENT z „ SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT PILE NUMBER: PROPOSED PARCELS Existing Square Proposed Square Parcel Number Existing or Proposed Use of Parcel Footage or Acreage Footage or Acrea e 1 Agriculture 32,670 sf 2 Agriculture 51.25 ac 3 Agriculture 10.00 ac SITE IMPROVEMENTS AND SERVICES Water Annex-Formation Distance to Public Public Water Service Provider Required Water Feet) Proposed ❑ E xiI stinq❑ Private Water® Existing Well [I New Well ® Well Replacement ❑ Sewage Disposal I Public Sewage Annex-Formation Distance to Public Disposal Service Provider Re uired Sewer Facility Proposed ❑ Existing ❑ On-site Sewage Disposal® Existing Septic System ElNew Septic System ® Other El Storm Drainage Public Storm Drainage Service Provider(if Public) Annex-Formation Terminal Drainage Detention-Retention h Required to: Ponds Proposed E] Existing ❑ Private Storm Drains e® 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 SBC Existing School Service Fire Protection Service I Distance to Elem Service Provider School Service Provider Distance to Fire Station Escalon Unified 3 mi Ripon 3 mi Existina Roads Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks Carrolton Road 40' 26' (estimate) Yes ❑ No Yes ❑ No Proposed Roads i Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks i N/A Yes ❑ No ❑ Yes❑ No❑ Yes ❑ Na ❑ Yes❑ No❑ FADEVSVMPIanning Application FormM Page 2 of 3 Job No 2007-214 LLA.doc Lot Line Adiustment.doc.(Revised 6.4-44)