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NOTE: PULL ALS f,ERMITS (Septic, Well, etc.) MAKI �aPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0005090 <br /> DATE RECEIVED by EHD: June 15,2005 APPL#: PA-0, <br /> Referral Agency STAFF CONTACT: GILLIA_N HAY_ PE : 2690 <br /> COMPLETE&SUBMIT BYAQ a { b LOT LINE ADJUSTMENT(LA) <br /> COMPLETE&SUBMIT BY: �° ■ <br /> Assigned to : EE0005944 ESCOTTO <br /> SITE ADDRESS: 26263 E DOVE RD, ESCALON APN: <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 /> / <br /> C recommend: Approval © Denial F—] Continuance F-1 Inspector: <br /> Signature <br /> F Suuervisor/Lead Senior COMMENTS: <br /> dV <br /> F <br /> 4x- <br /> SUPERVISOR <br /> x -5UPERVISOR/LEAD SENIOR Approval: Date: <br /> A 1 Ch k Off rsf I' ve iia - tcri e �<IE# W _. mm . <br /> 9R-fi <br /> r , <br /> .'�.r® ®R ew�r..r..-..w»--ea <br /> r <br /> EH 06 06 Report#7201 June 15,2005 <br />