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APPLICATION - LOT LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> Parcel Number Existing or Proposed Use of Parcel Proposed <br /> qunre Footage Square Footage <br /> or Acreage or Acreage <br /> PARCEL SITE IMPPOV#=MENTS AND SERVICES � <br /> W atvf <br /> Public Water Service Provider Annex-Formation Distance to Public <br /> Existing❑ Required Water (Feel <br /> Proposed❑ <br /> Private Water Existing Well p New Well ❑ Well Replacement ❑ <br /> at <br /> Public Sewage Service Provider Annex-Formation Distance to Public <br /> Disposal Required Sewer Facility <br /> Existing❑ <br /> Proposed❑ <br /> On-ske Sowape Existing Septic System New Septic System ❑ Other ❑ <br /> Disposal CX <br /> Storm Drains" <br /> Public Storm Service Provider Annex-Formatlon Terminal Drainage Detention- <br /> Drainage Required to: Retention Ponds <br /> Existing❑ <br /> Prcp.s^d ❑ <br /> Privnto Storm On-site Retention Pond(s) ❑ Natural Drainage/No Change Other ❑ <br /> Drainage IX <br /> t�leCfr{Gf4y N►luta[Gtet <br /> Service Provider Distance to Service Service Provider Distance to <br /> Service <br /> PG&E ON SITE PG&E ON SITE <br /> Telephone 5eryfce Cable 7elenrlslott 5etyltae <br /> Service Provider Distance to Service Service Provider Distance to <br /> Service <br /> PACIFIC BELL ON SITE NOT APPLICABLE <br /> Schetit t3ervtee <� FH'i!t PriA!ltdlf0s'!SMtVFCa <br /> Service Provider Distance to Elam Service Provider Distance to Fire <br /> School Station <br /> L.U. S.D 3MILES WOODBRIDGE FIRE DEPT 3 MILES <br /> Exfstlnti Ficads <br /> IRoad/Slreot Name R.O.W.Width Pavement Width Curb/❑utter Sidewalks <br /> I FRONTAGE ROAD Yea ❑ Noll Yee❑ No EX <br /> i <br /> Yes ❑ No❑ Yee ❑ No❑ <br /> Proposed E�ot:ds <br /> Road/Street Name R.O.W. Width Pavement Width Curb/Gutter Sidewalks <br /> NOT APPLICABLE Yes ❑ No❑ Yes❑ No❑ <br /> Yes❑ No❑ Yes O No❑ <br /> -3- <br />