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' NOTE: PULL ALL:2RMITS (Septic, Well, etc.) MAKE�vOPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0006161 <br /> DATE RECEIVED by EHD: August 01,2006 APPL#: PA-0600066 REV Sl <br /> Referral Agency STAFF CONTACT: MO HATEF PE : 2631 <br /> SITE APPROVAL-MINOR(SA) <br /> COMPLETE& SUBMIT BY: Mon, August 21, 2006 <br /> Assigned to : EE0005944 ESCOTTO <br /> SITE ADDRESS: 17142 N FOX RD, LODI APN : 05119024 <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 /> ' lfi�C�.�dLl7�/G=�i�iA19��75� .✓S ilA./�1/cJ� f�-lE3J�L SE���tL ,cE�i <br /> /nq'7iZ321AZ K5,01z---) / fxi- Ct-f3`YE CUZr��. <br /> ��7L�79S����Iiy��1li.L�.t-iL� � Sf,�s) �!/C 11�„t',✓i/t� �/fJ. L�s+IY/�l�f[�i14� <br /> A)SM�EC:P Dl rt fzS� t ✓.?� <br /> eZ=2T E eif-'E 3J/ZA2fe r/11//:dL4117� /J�.l!) <br /> I recommend: Approval © Denial ❑ Continuance ❑ Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> SUPERVISOR/LEAD SENIOR Approval: .v Date: . ;.2 <br /> Ell 06 06 Report#7201 August 01,2006 <br />