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L NOTE: PULL ALL?i�RMITS (Septic, Well, etc.) MAKE e-v`PIES FOR FILE <br /> LAND USE REPORT RECORD ID: :Pit-0qX 5L)0W 5a23 <br /> DATE RECEIVED by EHD: May 03,2005 APPL#: PA-0400789 5U(X 05Ca��(SU) <br /> Referral Agency STAFF CONTACT: RAYMOND HOO PE : 2611 <br /> SGBDIVISIOY-MAJOR(SLI) <br /> COMPLETE& SUBMIT BY: — <br /> Assigned to : EE0005944 ESCOTTO <br /> SITE ADDRESS: 4860 E MAIN ST, STOCKTON APN : 173321004 TO 07 <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 /> -d 2FZ uzD moi— its« .f � '✓L BpS ) <br /> ZzAllyl /�i�t �7� (tea 'ao /-� - Az;a) 34-2s�� 1 <br /> I recommen : Approval ©' Denial ❑ Continuance ❑ Inspecto <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> yoz, ay <br /> s , <br /> - 4 <br /> c- <br /> PR6 <br /> z 72 <br /> o :a <br /> 20 . Os <br /> SUPERVISOR/LEAD SENIOR Approval: — Date: G �d <br /> OA 11 Check Off List: Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report 47201 May 09,2005 <br />