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NOTE: PULL Abwv-f-RMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0005249 <br /> DATE RECEIVED by EHD: July 25,2005 APPL#: PA-0500453 <br /> Referral Agency STAFF CONTACT: KARLA KUHL PE : 2622 <br /> SUBDIVISON-MINOR(MS) <br /> COMPLETE & SUBMIT BY: Tue, August 16, 2005 <br /> Assigned to : EE0005366 MEDINA <br /> SITE ADDRESS: 23233 N JACK TONE RD, ACAMPO APN : 00728022 <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: /ne7 Lc Public Sewer: iJz <br /> NarlN of Purveyor �Y �F N e of ystern <br /> SUMMARY OR COMMENTS: <br /> aa-A- ria r C� / <br /> I recommend: Approval Denial ❑ Continuance ❑ In � <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> V <br /> C 1 <br /> mow . <br /> SUPERVISOR/ LEAD SENIOR Approval: - Date: <br /> OA II Check Off List: ProofreadReport'? Correct LAND USE d? <br /> Correct CONDI"IION(S)'. Lugged in LAND USE Hook? <br /> J <br /> FH 06 06 Report 47201 July 26,2005 <br /> r <br />