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NOTE: PULL ALkr#ERMITS (Septic, Well, etc.) MAKE OPIES FOR FILE <br /> LAND USE REPORT RECORD ED: SU0004818 <br /> DATE RECEIVED by EHD: February 01,2005 APPL#: PA-05-35 <br /> Referral Agency STAFF CONTACT: KATHY ALLEN PE : 2622 <br /> /� SUBDMSON-DIINOR(MS) <br /> COMPLETE&SUBMIT BY: Tue, February 1 , 2005 <br /> Assigned <br /> to : EE0005944 ESCOTTO <br /> SITE ADDRESS: 19300 W GRANT LINE RD, TRACY APN : 20906011,& <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 /> -.T-t4E12LF114.0= 0711I?/�5l<�71�o✓fcc6Fe�7jt'St1 <br /> T 56�7iL rf-&nE 6 - �/?y a45p--W l 4!!o9s Td ;-,-W <br /> I recommend: Approval Er Denial El Continuance El Inspect <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> • ;22 3 <br /> C . u : 03 0.. <br /> D, Aa-- al <br /> SUPERVISOR/LEAD SENIOR Approval: v Date: J <br /> OA it Check OH List Proofread Report? Correct LAND USE#? <br /> Correa CONDITIONS)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 Page 2 February 11,2005 <br />