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APPLICATION - LOT LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> PROPOSED PARCELS <br /> Parcel Number Existing or Proposed Use of Parcel Existing Proposed <br /> Square Footage Square Footage or <br /> or Acreage Acreage <br /> SITE IMPROVEMENTS AND SERVICES <br /> Water <br /> Public Water Service Provider Annex-Formation Distance to Public <br /> Existing❑ Required Water(Feet) <br /> Proposed❑ <br /> Private Water❑ Existing Well >r& New Well ❑ Well Replacement ❑ <br /> ._..._._.__......... <br /> ._.......... .. ...... <br /> Sewage Dis sai <br /> Public Sewage Service Provider Annex-Formation Distance to Public <br /> Disposal Required Sewer Facility <br /> Existing❑ <br /> Proposed❑ <br /> On-site Sewage Existing Septic System Ja New Septic System ❑ Other ❑ <br /> Disposal❑ <br /> _. __ ..__. .. _. <br /> _ Storm Drainage <br /> Public Storm Service Provider Annex-Formation Terminal Drainage Detention- <br /> Drainage Required to: Retention Ponds <br /> Existing❑ <br /> Proposed❑ <br /> Private Storm I On-site Retention Pond(s) ❑ Natural Drainage/No Change ❑ Other ❑ <br /> Draina e❑ <br /> Electricity Natural Gas <br /> Service Provider Distance to Service Service Provider Distance to Service <br /> S23 v, <br /> ` u <br /> Telephone Service Cable Television Service <br /> Service Provider Distance to Service Service Provider Distance to Service <br /> School Service Fire Protection Service <br /> Service Provider Distance to Elem Service Provider Distance to Fire <br /> School Station y <br /> Existin Roads ' <br /> Road/Street Name R.O.W.WidthPavement Width Curb/Gutter Sidewalks <br /> Yes❑ No❑ Yes❑ No❑ <br /> c• <br /> Yes❑ No❑ Yes❑ No❑ <br /> Proposed Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> Yes❑ No Yes❑ NoA, <br /> I <br /> Yes 0 No 0 Yes 0 No❑ <br />