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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE %..PIES FOR FILE n <br /> LAND USE REPORT RECORD ID: SU0004970 <br /> DATE RECEIVED by EHD: April 05,2005 APPL#: PA-05-185 <br /> Referral Agency STAFF CONTACT: RAYMOND HOO PE ; 2622 <br /> COMPLETE& SUBMIT BY: Tue, April 79, 2005 SIIBDIVISON-MINOR(MS) <br /> Assigned to : EE0005944 ESCOTTO <br /> SITE ADDRESS: 451 DIETRICH RD,LINDEN APN : 10521020& <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 /> _ !.t✓ �t31jC3c1: 1J! [_� �/ L/&Z,zzD <br /> 'o G ! .� Z2:6 <br /> I recommend: Approval © Denial Continuance Inspector- <br /> El <br /> - <br /> Supervisor/Lead Senior COMMENTS: Signature <br /> aZ w1r- d :)L V <br /> • af <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> OA H Check Off List Proofread Report? Correct LAND USE# <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 Page 4 April 07,2005 <br />