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NOTE: PULL ALU..-ERMITS (Septic, Well, etc.) MAKE*,w6P1ES FOR FILE <br /> LAND USE REPORT RECORD ID: S00004987 <br /> DATE RECEIVED by EHD: April 12,2005 APPL#: PA-05-191 <br /> Referral Agency STAFF CONTACT: RICH GRIFFIN PE : 2631 <br /> SITE APPROVAL-MINOR(SA) <br /> COMPLETE&SUBMIT BY: Wed, April 27, 2005 <br /> Assigned to: EE0005944 ESCOTTO <br /> SITE ADDRESS: 9355 W HWY 4 , STOCKTON APN : 13109021 <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 /> —AGc Z15r1a;V: eEjz L (-V- ie�Aagmrs s 2m c--J UQ. <br /> 2c=GUGFI'� EdiD�trS . <br /> a /n/ <br /> b lo:o <br /> a� <br /> I recommend: Inior <br /> Approval Denial Continuance Inspector <br /> ignature <br /> Supervisor/Lead COMMENTS: <br /> It 1a'7 <br /> O <br /> 0 <br /> lfv <br /> d d.LJ <br /> fry/ �M12!/ ✓ /N Ill! ��s/9 2 s� <br /> SUPERVI. 011/ LEAD SENIOR Approval: Date: <br /> OA 11 Check Off List Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report 37201 Page 3 April 13.2001 <br />