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NOTE: PULL AU.,_,�ERMITS (Septic, Well, etc.) MAK!, ,PPIES 1=0R PILE <br /> LAND USE REPORT RECORD ID: SU0008843 <br /> DATE RECEIVED by EHD: August 01,2011 APPL#: PA-1100124 <br /> Referrai•Agency STAFF CONTACT: RICK GRIFFIN PE : 2632 <br /> SITE APPROVAL-GENERAL(SA) <br /> E COMPLETE & SUBMIT BY: Tue, August 16, 2011 <br /> Assigned to: EE0005944 ESCOTTO <br /> SITE ADDRESS: 6041 E KETTLEMAN LN, LODI APN : 04923011 <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 /> w /� <br /> - <br /> i - i <br /> Z:V"Al <br /> d3 ) -- <br /> [ recommend: Approval �- Denial Continuance Inspector. <br /> ignature <br /> E Supervisor/Lead Senior COMMENTS: <br /> 2— <br /> SUPERVISOR <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> DA �rd>E <br /> `�-;a?yP •,-�s!�f � s.-�i�.a. ?s u.t 1ic..e;«.. <br /> 1l..CheCk Off.:: �.,eT,P�ofreaRe ort <br /> USes"E.<,ib?l;aa'�•1a.:.{..;.,.;�.«E�a.�Ep��4,,E.i C�tr,ryeCt�l A UF4i'6ot1 *Wow <br /> f; <br /> EH 06 06 Report#7201 August 0t,2011 <br />