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' NOTE: PULL AL7 ,RMITS (Septic, Well, etc.) MAKI y)PIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0005733 <br /> DATE RECEIVED by EHD: October 26,2005 APPL#: PA-0500481 <br /> Referral Agency STAFF CONTACT: RICK GRIFFIN PE : 2632 <br /> SITE APPROVAL.-GENERAL(SA) <br /> COMPLETE&SUBMIT BY: Tue, November 15, 2005 <br /> Assigned to : EE0004000 VAN DYNE <br /> SITE ADDRESS: 26639 E JONES AVE,ESCALON APN: 24718003 <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 pieceof 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 /> Lrf 5//rr <br /> W <br /> --le D r 7� .4 <br /> - Z 2. 6-3 2/0/,01 n 1.551 &C.-.e 4K- <br /> I recommend: Approval ❑ Denial ❑ Continuance ❑ Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> �f <br /> 1 <br /> ZZ; o <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> k Ot.[ <br /> a OA ll Checff Litt- <br /> l?o Lorre :L ]� ' x ` <br /> = <br /> EH 06 06 Report 47201 October 27,2005 <br />