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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKEOPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0004991 <br /> DATE RECEIVED by EHD: April 19,2005 APPL#: PA-05-221 <br /> Referral Agency STAFF CONTACT: JENNIFER JOLLEY PE : 2631 <br /> SITE APPROVAL-MINOR(SA) <br /> COMPLETE& SUBMIT BY: Wed, April 27, 2005 <br /> Assigned to: EE0005944 ESCOTTO <br /> sm ADDRESS: 24837 E MILTON RD,ESCALON APN : 09314008 <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 /> / <br /> J <br /> ,98cit; a o:o � Caen <br /> :d <br /> I reco mend: Approval Denial ❑ Continuance ❑ Inspecto . <br /> Signature <br /> Su ervis r/Lead Senior COMMENTS: <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> OA II Check OH List Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report 47201 Page I April 21,2005 <br />