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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0009140 <br /> DATE RECEIVED by EHD: April 06,2012 APPL#: PA-1200053 PRE APP <br /> Referral Agency STAFF CONTACT: MO HATEF PE : 2632 <br /> SITE APPROVAL-GENERAL(SA) <br /> COMPLETE&SUBMIT BY: Wed, May 2, 2012 <br /> /7-3 Assigned to: EE0005944 ESCOTTO <br /> SITE ADDRESS: 1601 N BUDISELICH RD, STOCKTON APN: 1012100410122003 <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: _ 7/��r��/� � j � ��Ec <br /> J� <br /> 0 <br /> Tifr 517c G�+✓sV-5 67-L <br /> • �Fft�S'i7���E7tr2`y'c�13fi�cr�< 1�3L1�G���3C,/T.clJ7/�/RG� s2.i�n <br /> 1 recommend: Approval Denial Continuance Inspecto . <br /> Supervisor/Lead Senior COMMFNT Signature <br /> Rre <br /> h ' O 7 ` fssv <br /> 2 , -74� <br /> 0-1 2a : 0y <br /> c) il- o � dal <br /> SUPERVISOR/LEAD SENIOR Approval: <br /> OA 11 Check Off List' Proofread Report? c1 Correct LAND USL#? <br /> Conect CONDI I10N(S)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 <br /> J April 06,2011 <br />