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NOTE: PULL ALLY.-ERMITS {Septic, Well, etc.} MAKE'uPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0004121 <br /> DATE RECEIVED by ERD: May 12,2004 <br /> APPL#: PA-04-239 <br /> Referral Agency STAFF CONTACT: BILL FACTOR <br /> PE : 2690 <br /> COMPLETE&SUBMIT BY: ■ Jt' l `� LOT LINE ADJUSTMENT(LA) <br /> r Assigned to : EE0001456 HESS <br /> SITE ADDRESS: 23377 S MOUNTAIN HOUSE PKWY TRACY <br /> � APN: 20908015 <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 /> � <br /> SUMMARY OR COMMENTS: <br /> F <br /> a <br /> C <br /> I recommend: Approval [2---'Denial Continuance Inspector: <br /> f <br /> Supervisor/Lead Senior COMMENTS: Signature <br /> VZe <br /> . O <br /> ZL IA3 <br /> SUPERVISOR/LEAD SENIOR Approval: ! Date: <br /> OA 11 Check Off List: Proofread Report? i Correct LAND USE#? <br /> Correct CONDI'nON(S)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 Page 12 <br /> May 12,2004 <br />