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i APPLICATION - LOT LINE ADJUSTMENT SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT .........:..................... . 1. : :<>> 'iii>`::> <':><:»: > <i:ii><;<:: ....:......:.............:.... Existing Proposed Parcol Number Existing or Proposed Use of Parcel Square Footage Square Footage or Acreage or Acreage Cl iii::.::i:.:i;:::ii):iii::.i�:::.;:`:ii:ii:�ii::�:i:}:v::,:;:��i:::i.::�::•.:•::.i::• :;>';:>::::isi::i;�::»:>::;::.;><:>:>:::•;:::;>:'>;<:..;>�:;>:;:.;;::::::>:<::i;:::ii:.: tMp�ApV(�.t��NTS:ANp,S� . :.:........:..... ::.....::::.:.. ::::.:.......:..:.. ............ Service Provider Annex-Formation Distance to Public Public Water Roquirod Water(Foot) Existing❑ Proposod O Existing Well ❑ Now Woll ❑ Woll Replacement ❑ Private Wnlor O g :•::::';i:;; :.::ii•i. Sawngp[glupa9al ..;` Service Provider Annex-Formation Distance to Public Public Sewage noqulred Sower Facility Disposal Existing' / / Propose �L�b J/�� i So On-silo Sewage Existing [3Now Septic SYstem ❑ Othe� Septic�stem , Disposal❑ 8orrn Drain g Public Storm Service Provider Annex-Formation Terminal Drainage ne Dnte ntioon - Roquirod tO Ponds Dralno , Existing Proposed❑ Private Storm On-silo Retention Pond(s) ❑ Natural Drainago/No Change: Other ❑ Drainage❑ _ .. Service Provldor Distance to Service Provider Distance to Service Service . ..:: . ........ Service Provider Distance to Service Provider Distance to Service Service i•:::;:;•.:>,:.;:::::;;<.':•:••:..... Distance to Fire Distance to am Service. Provldor ElService Provider Station School / . " ' Sidewalks Road/Street Name R.O.W.Width Pavement Width Curb/Gutter' Yea❑ No Yea❑ No Yas❑ No D Yes❑ No❑ d► :::::....... .... ........:.:•:::...:.::::::...:.::::�:,�:......:..::::.:,.::.....:...... ...........:.:..... >::.pro :n . Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks w elks Yea D No❑ Yoe❑ No D lf� � Yas❑ No D Yes D No❑ -3-