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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0009551 <br /> DATE RECEIVED by EHD: March 01,2013 APPL#: PA-1300031 <br /> Referral Agency STAFF CONTACT: CORINNE KING PE: 2632 <br /> SITE APPROVAL-GENERAL(SA) <br /> COMPLETE&SUBMIT BY: Wed, March 13, 2013 <br /> Assigned to: EE0005944 ESCOTTO <br /> SITE ADDRESS: 14239 E KETTLEMAN LN,LODI APN: 05304012 <br /> [n 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 �` J • � ��3 j �(�yJ�Q � �/ {ZC7� <br /> ��tX/LcCA1. -OF� ZEfZ �iP� /�lE �•}>fyl 7ZG1��/C<b Fif�ia< <br /> A �-�i� srvrs+� yJ12�15 h �1 A®rl�lr�LGE7d <br /> 4E?�Rkl-4,:s/4r0 Li-`--z[ s- <br /> .fid//fie dof-t /ey /S rdG3L -'JA/ c ffPa"j- <br /> A'e) ��i[- OL �� /� ?�l <L![�C� cz�/Cdt.14 t �� 5 <br /> t recommend: Approval L±1 Denial F-] Continuance r Inspector: - <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> o aI A <br /> A 22.0 7 <br /> M • n.�vr� <br /> STI 1 z <br /> SUPERVISOR/LEAD SENIOR Approval: Date: / <br /> OA if Check Off List: . .Proofread Report? Correct 1.ANDUSF,# ? <br /> Correct CONDI'1'LON(S)'? Logged in LAND USP:Book? <br /> EH 06 06 Report#7201 Msi`1'111 '111 <br />