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NOTE: PULL ALL PEWITS (Septic, Well, etc.) MAKE COMS FOR FILE <br /> LAND USE REPORT RECORD ID: SU0004896 <br /> DATE RECEIVED by EHD: March 08,2005 APPL#: PA-05-108 <br /> Referral Agency STAFF CONTACT: RICK GRIFFIN PE : 2631 <br /> SITE APPROVAL-MINOR(SA) <br /> COMPLETE &SUBMIT BY: Tue, March 22, 2005 ()S0 M VT`99;.5/ <br /> Assigned to : EE0004156 1J. \/e-,Dy r e <br /> SITE ADDRESS: 1444 S MARIPOSA RD, STOCKTON APN : 17302054 <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 /> .(rev .h "1�;u� aAt `If <br /> I recommend: Approval ❑ Denial ❑ Continuance El Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> SUPERVISOR/LEAD SENIOR Approval: Date: �D 0 <br /> OA 11 Check Off List Proofread Report? V Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report 117201 Page 2 March 09,2005 <br />