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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0003428 <br /> DATE RECEIVED by EBD: April 20,2004 APPL#: PA-04-179 <br /> Referral Agency STAFF CONTACT: JENNIFER JOLLEY PE : 2622 <br /> SURD WISON-MINOR(MS) <br /> COMPLETE&SUBMIT BY: Tue, May 4, 2004 Assigned to: EE000o 149 BORGES <br /> SITE ADDRESS: 1248 W HAMMER LN, STOCKTON APN : 00749004&05 <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 El Denial 0 Continuance Inspector: <br /> Sign ier <br /> Supervisor/Lead Senior COMMENTS: <br /> p • O S a, <br /> (S! /'mow c� �e�PH <br /> 04 , aowtL <br /> n ff <br /> 2r <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> OA 11 Check Off List: Proofread Report? Correct LAND USE#? <br /> Correct CON/DDMON(SL)??�w/Jy� Logged in LAND USFF///85ok? �t <br /> EH 06 06 Report#7201 •✓ _ 2 V (J.Y Pagp N /,� OXTC ,{/, T7 �Q.CXG{,y April 20� <br /> .JJ 9,111g), 3 <br />