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r r-1) <br /> NOTE: PULL ALL' •RMITS (Septic, Well, etc.) MAKE t —F--ES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0006170 <br /> S DATE RECEIVED by EHD: August 08,2006 APPL#: PA-0600426 <br /> Ji Referral Agency STAFF CONTACT: KATHY ALLEN PE : 2690 <br /> LOT LINE ADJUSTMENT(LA) <br /> COMPLETE&SUBMIT BY: [lye. <br /> ,. <br /> Assigned to : EE0005366 MEDINA <br /> SITE ADDRESS: 21501 E HARNEY LN, LODI APN : 05321001 <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: ��y� Public Sewer: �i� <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: <br /> f <br /> I recommend: Approval Denial Continuance Inr <br /> ignature <br /> 1 Supervisor/Lead Senior COMMENTS: <br />{ <br /> f ' <br /> Ir4 <br /> I <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> Cr.. <br /> DA1shec�ff LiSt'. � i%�sfre <br /> .. ., e.�-.�.we..a a....:.,...... ,' r <br /> EH 06 06 Report#7201 August 08,2006 <br /> 1 <br />