Laserfiche WebLink
MH <br />NOTE: PULL ALL PERMiiS (SEPTIC, WELL, ETC...) MX�E COPIES FOR FILE <br />RECORD ID#: SU0004745. PE: 2622 <br />LAND USE REPORT APP#_PA-04-726 (LA & MS) <br />EHD RECEIVED APP. REFERRAL: 12/7/04 COMPLETE & SUBMIT BY: IJ! ,2I% Ot/ <br />DATE DATE <br />SITE ADDRESS: 16300 NORTH JACK TONE ROAD LODI <br />In completing the Land Use investigation, draw all Public Health factors on the exhibit (i.e.: sewage disposal, <br />water supplies, etc...). Where necessary, on an attached piece of plain paper, draw a completed map of area <br />showing population density, location of house, wind direction, etc.... <br />Public water: <br />SUMMARY OR COMMENTS: <br />Public sewage: <br />I recommend: Approval Denial Continuance Inspector's Signature <br />Supervisor/Lead Senior Comments: <br />SUPERVISOR/LEAD SENIOR APPROVAL: <br />D(DP co-ed dA& 01141'01' <br />E11 06 06 Rev 1/99 I OA H CHECK OFF LIST: _ Proofread report? _ Correct LAND USE #? <br />Correct CONDITION(S)? Logged in LAND USE BOOK? <br />