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NOTE: PULL ALL IERMITS (Septic, Well, etc.) MAKE CQPIES FOR FILE' <br /> LAND USE REPORT RECORD ID: SU0004518 <br /> DATE RECEIVED 6y EHD: June 18,2004 APPL#: PA-04-317 <br /> Referral Agency STAFF CONTACT: RICK GRIFFIN PE : 2690 <br /> ` y LOT LINE ADJUSTMENT(LA) <br /> COMPLETE& SUBMIT BY: �t Assigned to : EE0000149 BORGES <br /> SITE ADDRESS: 1298 W HARNEY LN, LODI APN : 05806001 & 02 <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 /> tl <br /> I recommend: Approval Denial Continuance Inspector/f"-. <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> 'SUPERVISOR/LEAD SENIOR Approval: Date: <br /> Obi 1l Check- <br /> OffProofread Report?:. <br />• List. =� ,....< Correct <br /> LAND USE#? <br /> Correct CONDITION(S)`? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 Page 1 June 21,2004 <br />