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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0009749 <br /> DATE RECEIVED by EHD: September 06,2013 APPL#: PA-1300146 <br /> Referral Agency STAFF CONTACT: JOHN FUNDERBURG PE : 2690 <br /> LOT LINE ADJUSTMENT(LA) <br /> COMPLETE&SUBMIT BY: 1 172 13 <br /> Assigned to: EF0005944 ESCOTTO <br /> SITE ADDRESS: 17016 N JACK TONE RD,LODI APN : 05303020,46,47&53 <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 /> /�/12Gr�'0I/ L/Y�S ZGfYtrb�'� moi//�J�7Hf} Sc�'Z�c 5/9_EM. Tiff l B« 4a4a+,cOFs� <br /> r i <br /> rj,,,(�}�iv„l i.-.s ,z,�e�J6S Z�-// lc!/,1-- Zs��i2 t�Cex/5rS7S cF'Gsr,[C-?JE_2ri�✓Crl�to. <br /> �A1cs s z. 3L d2t�yC=jz-'A";J vr -- <br /> I recommend: Approval12/ Denial F Continuance F Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> SUPERVISOR; LEAD SENIOR Approval: Date: <br /> OA H Check Off List: 'proofread Report? Coneet LAND USE 49 <br /> Comet CONDrrioN(S)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 <br />