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i <br /> Service Facilities Needed City, Special District, etc. <br /> Water rk 1pst;r 11 n . <br /> Sewa a ='—fir T,nL <br /> Drainage !./a <br /> Electricity P <br /> Gas Kristin F_ <br /> —P_ r_ & r^ <br /> What is the purpose of the proposed Line Line Adjustment: <br /> `lQ_SrEato a m reyiahi p }^.Yc'r '+rOL71C� I1 '�1� COi]Gtrttrteci hmie <br /> Proposed property size and use: <br /> Parcel A size:_ 1.37 acres use: iia.,esite <br /> Parcel B size: 21.6 acre-, use : a--ricultural <br /> Parcel C size: use: <br /> Parcel D size: use: <br /> I certify under penalty of perjury that I am (check one ) : <br /> �y] Legal Owner ( s ) (All owners must sign as their names appear on the <br /> deed. ) , <br /> [] Corporate Officer (s ) empowered to sign for the corporation, <br /> U Owner 's legal agent (attach proof of the owner's consent to file <br /> the application ) , <br /> and that the foregoing is true and correct . <br /> �A l l L <br /> (Sgn j <br /> bre ) (Date ) <br /> ( Signature ) (Date ) <br /> (Signature ) (Date ) <br /> (Signature ) (Date ) <br /> Lot Line Adjustment - 6 - (8/85 ) <br />