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1 F 1i Rs _ <br /> NOTE: PULL ALL' ERMITS (Septic, Well, etc.) MAKE COTES FOR 1`ILE <br /> LAND'USE REPORT RECORD ID: SU0004895 <br /> - <br /> DATE RECEIVED by EHD: March 08,2005 APPL#: PA-05-53 <br /> Referral Agency STAFF CONTACT: KATHY ALLEN PE : 2690 <br /> LOT LINE ADJUSTMENT(LA) <br /> COMPLETE& SUBMIT BY: Ap. 41' 3I/ 6! <br /> r Assigned to : EE00041-�6 <br /> SITE ADDRESS: 27043 E JONES RD, ESCALON APN: 24719004 <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 /> I recommend: Approval F-1 Denial ❑ Continuance F-1 Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> r / <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> OA I/Check Off List: Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 Page 1 March 09,2005 <br />