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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE SPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0005096 <br /> DATE RECEIVED by EHD: June 15,2005 APPL#: PA-0500341 <br /> Referral Agency STAFF CONTACT: KATHY ALLEN PE : 2631 <br /> SITE APPROVAL-BIINOR(SA) -- <br /> COMPLETE & SUBMIT BY: Tue, July 5, 2005 <br /> Assigned to : EE0005366 MEDINA <br /> SITE ADDRESS: _ 13050 E JAHANT RD,ACAMPO APN : 00727009 <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: /yuTy� Public Sewer: �harii <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: ��j' �.�;�� -�J����1�/ �«..� c� c�—��rcc cv-t <br /> o <br /> I recommend: Approvalp�:J—DeLnial Continuance 0 n Inspector <br /> Signat re <br /> Supervisor/Lead Senior COMMENTS: <br /> -.tD�u-oML9— <br /> ID <br /> ri <br /> 1 � <br /> SUPERVISOR/ LEAD SENIOR Approval: - _ Date: �7o-r J _ <br /> OA 11 Check Off List Proofread Report? - Correct LAND USE N 7 <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> LH 06 06 Repon=T_'i 1 lune 16,2005 <br />