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SU0005852
EnvironmentalHealth
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SU0005852
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Last modified
10/28/2020 5:23:19 PM
Creation date
9/6/2019 10:14:55 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0005852
PE
2611
FACILITY_NAME
PA-0400492
STREET_NUMBER
21489
Direction
E
STREET_NAME
MONDY
STREET_TYPE
LN
City
LINDEN
APN
18332021, 67, &
ENTERED_DATE
12/28/2005 12:00:00 AM
SITE_LOCATION
21489 E MONDY LN
RECEIVED_DATE
12/27/2005 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\wng
Supplemental fields
FilePath
\MIGRATIONS\M\MONDY\21489\PA0400492\SU0005852\SURV MEMO.PDF
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EHD - Public
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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0005852 <br /> DATE RECEIVED by EHD: December 27,2005 APPL#: PA-0400492 <br /> Referral Agency STAFF CONTACT: RICK GRIFFIN PE : 2611 <br /> SUBDIVISION-MAJOR(SU) <br /> COMPLETE & SUBMIT BY: Wed, January 11, 2006 <br /> Assigned to : EE0005944 ESCOTTO <br /> SITE ADDRESS: 21489 E MONDY LN, LINDEN APN : 18332021,67,& <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 /> A116 dct✓ G) <br /> LC— <br /> . <br /> • �/�� Go-� /-i5cco✓sis7 ar L/�e�c�!3��/.t1�i�-4�9s-9�L�rr�le� <br /> L�iilr�li�LO/5 9 to it ,4 /,f <br /> ;7A-, Tv�frw t*-- 1J✓LYGv7c3 T IAS is7i�6 S �SYSI l'�t�3 k'7 /1 ff ls�[3fr/�it,J <br /> is Za�3CTPE3Dc�. <br /> I recommend: Approval Denial Continuance F Inspector: <br /> Signature <br /> r ' I <br /> r � L`/ JI 2L.dJ <br /> Supervisor/Lead Senior COMMENTS: <br /> 42 <br /> 20a <br /> wn <br /> Tkt ��- J1 -(lAP �Ttc,a I e�,� to 7�It �hea.v.�•�� � s� A�� _ . , . <br /> R-cncn <br /> D IrrX 3 <br /> t o 3 w- S55 Z S <br /> E ZZ l O <br /> SUPERVISOR/LEAD SENIOR Approval: Date: 71ka <br /> -OA 11 Check Off List Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged iu LAND USE Book? <br /> EH 06 06 Report#7201 1)ecem bei 29,2005 <br />
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