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NOTE: PULL ALL .-ERMITS (Septic, Well, etc.) MAKE ..COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0008936 <br /> DATE RECEIVED by EHD: October 14,2011 APPL#: PA-1100193 <br /> Referral Agency STAFF CONTACT: RICK GRIFFIN PE : 2631 <br /> SITE APPROVAL-MINOR(SA) <br /> COMPLETE At SUBMIT BY: Wed, October 26, 2011 <br /> Assigned to : EE0005944 ESCOTTO <br /> SITE ADDRESS: 17875 N HILLSIDE DR,LODI APN : 05325003 <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: -— 7 �� t i ;� f , /� c [-;� <br /> L T��i✓�Ftin.;� �%�c�[4�.c.-= ilr! -1 ui�%r� .-�yS�ral� ���Y1���� l.�t�c �1 <br /> �t+1.) L`ysi5�`- /�c _ ,fixe <br /> !//�f'�UYSr�I ✓ E IrLE�d t NL[�i '6 4 /5 Ceemezi7lV GG situ 2t� <br /> 41 <br /> t recommend: Approval Denial Continuance F Inspector: <br /> Signature <br /> Supervisor[Lead Senior COMMENTS: <br /> 4;LTFRVISOR/ LEAD SENIOR Apprucal: Date <br /> OA II Check Off List: Proofread Report^ Correct LAND UST N <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report 47201 October 17,2011 <br />