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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0006377 <br /> DATE RECEIVED by EHD: December 28,2006 APPL#: PA-0600671 <br /> Referral Agency STAFF CONTACT: JASON JONES PE : 2690 <br /> BV' LOT LINE ADJUSTMENT(LA) <br /> COMPLETE& SUBMIT BY: <br /> -ASA P. i Assigned to : EE0005366 MEDINA <br /> SITE ADDRESS: 14680 E JAHANT RD, ACAMPO APN: 02105014 <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: /;�) 2E Public Sewer: <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: <br /> I recommend: Approval ❑ Denial ❑ Continuance In Peet <br /> Supervisor/Lead Senior COMMENTS Sigture <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> Im ,-a �Ir� ttii► CIF�D" i}�Ir <br /> EH 06 06 Report s#7201 December 28,2006 <br />