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NOTE: PULL ALL'PFRMITS (Septic, Well, etc.) MAKE'CUPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0005745 <br /> DATE RECEIVED by EHD: November 01,2005 APPL#: PA-0500737 <br /> Referral Agency STAFF CONTACT: ANTONIO SALCEDO \ PE: 2690 <br /> WO <br /> LOT LINE ADJUSTMENT(LA) <br /> A 06" A COMPLETE& SUBMIT BY: mAssigned to 1 <br /> FE 3t � EE0005366 ME�IN� <br /> SITE ADDRESS: 18624 E ALMOND CT, CLEMENTS APN : 01925016& 18 <br /> In completing the Land Use investigation, draw all Public Health factors on the exhibit(i.e., sewage disposal, water <br /> supplies, etc...). Where necessary, on an attached piece of plain paper, draw complete map of area showing population <br /> density, location of house, wind direction, etc.... <br /> Public Water: Public Sewer: <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: <br /> I recommend: Approval F-1 Denial ❑ Continuance ❑ Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> w <br /> SUPERVISOR/LEAD SENIOR Approval: Date: !/(f d; 6 <br /> OA it Check Off List: Proofread Report? Correct LA]b USE#? <br /> Correct CONDITION(S)? Logged in LAND X15,) Book?: <br /> EH 06 06 Report 97201 November 03,2005 <br />