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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE'E'OPIES FOR FILE <br /> LAND USE REPORT RECORD ID: S00004995 <br /> DATE RECEIVED by EHD: April 19,2005 APPL#: PA-05-157 <br /> Referral Agency STAFF CONTACT: KARLA KUHL PE : 2622 <br /> SUBDIVISON-MINOR(MS) <br /> COMPLETE& SUBMIT BY: Tue, May 3, 2005 <br /> Assigned to : EE0009374 GODEVHO <br /> SITE ADDRESS: 23725 S FREDERICK AVE, RIPON APN : 22813023 <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 /> �•�Q IJ <br /> 3 5 <br /> 02 <br /> —A <br /> E <br /> I recommend: Approval Denial Continuance Inspector• <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> ma <br /> D /i • o3 � <br /> a <br /> SUPERVISOR/LEAD SENIOR Approval: -7", _ Date: ?' / <br /> OA 11 Check OH List: Proofread Repon? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 Page I April 21,2005 <br />