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NOTE: PULL ALLftRMITS (Septic, Well, etc.) MAKE C PIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0005262 <br /> DATE RECEIVED by EHD: August 01,2005 APPL#: PA-0500484 <br /> Referral Agency STAFF CONTACT: KARLA KUHL PE : 2632 <br /> SITE APPROVAL-GENERAL(SA) <br /> COMPLETE& SUBMIT BY: Tue, August 16, 2005 <br /> Assigned to : EE0005944 ESCOTTO <br /> SITE ADDRESS: 690 W FREWERT RD, LATHROP APN : 19126023 <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 /> tzei !S �i�/.�syl infT/1t.. 1 z'r�h1 s� /�yist �eec /t 7/�/ylia/i�ru nvs <br /> /-1)1Lr767�/�Ilr.fb GYJCS/� l. .rPTlry RC1//1Yfn/L��flGccl�o CrlG�r72t/L� -7 7,5K Z . <br /> �Ti�7�G�6oe31G.c0 .�-S✓ �r�'-'-��.</7�9c�G'� �'!iJ/.i/c 6ft�i 5�� <br /> irl r ca�S : ill a fid"/ <br /> I recommend: Approval 2 Denial Continuance � Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> 13 :01 <br /> LIZ <br /> SUPERVISOR/LEAD SENIOR Approval: — Date: <br /> ... . . . .^•»e .,. <br /> OA 11 Check Off List: Proofread Report? " 'Correct LAND USE#? <br /> Correct CONDITION(S)7 Logged in LAND USE Book? <br /> io m Itepon NRii I - ,�� W �� q 'S Q,-0/ - August 02,2005 <br /> I`•//U4 J t� <br />