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\ NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE CZPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0006249 <br /> DATE RECEIVED by EHD: September 12,2006 APPL#: PA-0600066 REV <br /> Referral Agency STAFF CONTACT: MO HATEF PE : 2631 <br /> SITE APPROVAL-MINOR(SA) <br /> COMPLETE& SUBMIT BY: Wed, September 27, 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 /> 9iz-) <br /> Al ZJ2M COwk7c s <br /> I recommend: Approval Denial Continuance ElInspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> Ute- �e <br /> SUPERVISOR/LEAD SENIOR Approval: — Date: (s JV <br /> EH 06 06 Report#7201 September 13,2006 <br />