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NOTE: PULL AW-m-m-RMITS (Septic, Well, etc.) MAKE ..:PIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0005042 <br /> DATE RECEIVED by EHD: May 10,2005 APPL#: PA-0500285 <br /> Referral Agency STAFF CONTACT: RAY HOO PE : 2690 <br /> COMPLETE& SUBMIT BY: LOT LINE ADJUSTMENT(LA) <br /> Assigned to : EE0000149 BORGES <br /> SITE ADDRESS: 3782 E GUERNSEY AVE, STOCKTON APN : 15714051 <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 /> S r <br /> i <br /> I recommend: Approval F-I Denial Continuance Inspector: 'Rtb <br /> Supervisor/Lead Senior COMMENTS: Signature <br /> 1 <br /> w or, <br /> ,aro r� �_ .�. ����, , orm�. �, ,..�✓d-ua.d �;� ,�.� , <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> OA H Check Off List: Proofread Report? Correct LAND USE#? r <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> R <br /> EH 06 06 Report#7201 , May 13,2005 <br />