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2ecorot --ra;JL 5u0cp`3g0) P �. -,?,4JH <br /> NOTE: PULL ALL PERMITS (SEPTIC, WELL, ETC-) MAKE COPIES FOR FILE <br /> LAND USE REPORT APP#: PA-04-141 (LA) <br /> EIID RECEIVED APP.REFERRAL:-'A 31 104 COMPLETE & SUBMIT BY: '. ASAP-BY <br /> DATE DATE <br /> ATTN: JENNIFER JOLLEY <br /> SITE ADDRESS: 30467 SOUTH KOSTER ROAD TRACY <br /> In completing the Land Use investigation, draw all Public Health factors on the exhibit(i.e.: sewage disposal, <br /> water supplies, etc...). Where necessary, on an attached piece of plain paper, draw a completed map of area <br /> showing population density, location of house, wind direction, etc.... <br /> Public water: _A26 Public sewage: ,Fico <br /> SUMMARY OR COMMENTS: <br /> I recommend: Approval(� Denial Continuance Inspector's Signature <br /> Supervisor/Lead Senior Comments: <br /> K <br /> 3 0 � <br /> r. <br /> IV <br /> V <br /> A <br /> SUPERVISORILEAD SENIOR APPROVAL: <br /> Rx 06 06 Rev 1/99 OA II CHECKOFF LIST. Proofread report? Correct LAND USE#? <br /> Garrett CONDITION(S)? Lagged in LAND USE BOOK? <br />