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NOTE: PULL AL.LRMITS (Septic, Well, etc.) MAKE &I PIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0006558 <br /> DATE RECEIVED by EHD: May 09,2007 APPL#: PA-0500626 2, E � ' <br /> Referral Agency STAFF CONTACT: MO HATEF PE : 2690 <br /> LOT LINE ADJUSTMENT(LA) <br /> COMPLETE&SUBMIT BY: Tue, May 15, 2007 <br /> N Assigned to : EE0005366 MEDINA <br /> SITE ADDRESS: 10911"WY 88 , STOCKTON APN : 06311014 23 <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 /> �z ne, <br /> I recommend: Approval Denial Continuance Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> &- 1 � <br /> o fflnz <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> OA�!t(iheck:�ff Li$f Proofread Report? oreI� ND US <br /> s <br /> r_ ..: SCorrect a ggedinLl�pUE Bo�CONDMON(S)? <br /> �. .. <br /> HH 06 06 Report#7201 May 11,2007 <br />