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NOTE: PULL ALL)PPERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: S00004922 <br /> DATE RECEIVED by EHD: May 03,2005 APPL#: PA-0200092 <br /> Referral Agency STAFF CONTACT: RICK GRIFFIN PE : 2622 <br /> COMPLETE&SUBMIT BY: ,_ 2005 SURDIVISON-MINOR(MS) <br /> Assigned to: EE0000149 BORGES <br /> SITE ADDRESS: 15345 W GRANT LINE RD, TRACY APN : 20919032 <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 /> I recommend: Approval Denial F-1 Continuance F-1 Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> SUPERVISOR/LEAD SENIOR Approval: Date: `J <br /> OA 11 Check Oh List: Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 May 09,2005 <br />