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NOTE: PULL ALL�_„_RMITS (Septic, Well, etc.) MAKE's iP1ES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0005300 <br /> � -1 <br /> DATE RECEIVED by EHD: August 15,2005 APPL#: PA-0500513 <br /> Referral Agency STAFF CONTACT: CEALY LEIN - PE : 2690 <br /> Yff '311441W% LOT LINE ADJUSTMENT(LA) <br /> COMPLETE&SUBMIT BY: A 6A f 6 <br /> Assigned to: EE0005366 MEDINA <br /> SITE ADDRESS: 23233 N DUSTIN RD, ACAMPO APN : 00526014 <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: �aPublic Sewer: <br /> Nam Purveyor Nam of System <br /> SUMMARY OR COMMENTS: C�--- � <br /> I recommend: Approval Cffiial El Continuance F-1 Inspe to <br /> Sig store <br /> Supervisor/Lead Senior COMMENTS: <br /> i <br /> .y-- <br /> F <br /> i <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> ---:-, . <br /> D : r�a �: ; <br /> A Il Check OfF�tist -; ��Pronfread ReportC ` " Correct SAND USE#. <br /> . . <br /> Correct CONDITIONS)�:' ... Logged in LAND USE Boov <br /> EH 06 06 Report#7201 August 15,2005 <br />