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NOTE: PULL ALL%v-d"RMITS (Septic, Well, etc.) MAKE SPIES FOR FILE <br /> LAND USE RE-PORT RECORD ID: SU0007103 <br /> DATE RECEIVED by EHD: March 31,2008 APPL#: PA-0800097 PRE-APP Pre-Applica <br /> Referral Agency S'T'AFF CONTACT: JASON JONES PE : 2660 <br /> DEVIATION(DV) <br /> COMPLETE & SUBMIT BY: Wed, April 9, 2008 Assigned to : EE0005366 MEDINA <br /> SITE ADDRESS: 21301 N MANN RD, ACAMPO APN : 01728010 <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 /> V <br /> I recommend: Approval Denial Continuance <br /> Sign Lure <br /> Sunervisor/Lead Senior COMMENTS:_ <br /> SUPERVISOR 1 LEAD SENIOR Approval: Date: b <br /> .:..e k Off-Liii r 1'raofread Re pari ogre E USS <br /> OA fl Oh orrecfi ONDI'lfORO -V Log"p-& LANT3 Uwi-D66k, <br /> EH 06 06 Report#7201 March 31,2008 <br />