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NOTE: PULL ALL�_.RMITS (Septic, Well, etc.) MAKEr,--.;PIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0005305 <br /> DATE RECEIVED by EHD: August 15,2005 APPL##: PA-0500521 <br /> Referral Agency STAFF CONTACT: CEALY LEIN PE.- 2690 <br /> LOT LINE ADJUSTMENT(LA) <br /> COMPLETE& SUBMIT BQ AD a <br /> Assigned to : EE0004000 VAN DYNE <br /> SITE ADDRESS: 7595 W DELTA AVE, TRACY APN : 21302005&06 <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: i Public Sewer: <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: &7/- <br /> / <br /> /I d 0 <br /> 6 ll .fl er <br /> I recommend: Approval Denial Continuance Inspector: <br /> S_ upervisor/Lead Senior COMMENTSSignature: <br /> r <br /> i <br /> SUPERVISOR/LEAD SENIOR Approval: Date: 40 ax <br /> 0"A'01 Check Off List: Proofread �g�ect LAND USE.4"? <br /> 2 <br /> Correct CONI3M.9 S <br /> O? <br /> -- Loggedin LAND L# E..BooW- <br /> i <br /> EH 06 06 Report#7201 August LS,2005 <br />