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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0004816 <br /> DATE RECEIVED by ERD: February 01,2005 APPL#: PA-05-31 <br /> Referral Agency STAFF CONTACT: KEVIN SWANSON PE : 2631 <br /> SITE APPROVAL-MINOR(SA) <br /> COMPLETE&SUBMIT BY: Tue, February, 2005 <br /> - Assigned to: EE0005944 ESCOTTO <br /> SITE ADDRESS: 12565 S MANTHEY RD, LATHROP APN : 19124025 <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 /> - rte 5<e<Gl L4oue6 �i <e s74gtxc 'zee-.Am ;9.6�3 s 6 <br /> n tve�® G-rTn�er f irhbr/� v�� c� i <br /> zadLo_r-_2 -t/� cc Tsar s,.,mac r�1 b <br /> 520/1c__dk2z 74547� •CJO -E3L cZ Tic « c�r�f / �-?� <br /> S: <br /> 1Q1 Z2'o� <br /> I recommend: Approval12/ Denial Continuance Inspecto . <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> 4 <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> OA Il Check Off List: Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 <br /> February 11,2005 <br />