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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0009578 <br /> DATE RECEIVED by EHD: March 15,2013 APPL#: PA-1200126 RA <br /> Referral Agency STAFF CONTACT: MO HATEF PE: 2656 <br /> REVISIONS TO ACTIONS (RA) <br /> COMPLETE&SUBMIT BY: Tue, April 2, 2013 <br /> Assigned to: EE0005944 ESCOTTO <br /> SITE ADDRESS: 17036 N LOCUST TREE RD,LODI APN: 05112036 62 <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 /> ,A1 x L?u_ A��- /-,A/27/ 95 s-,,qZ 3J <br /> 29 70,12-, <br /> I recommend: Approval 2 Denial ❑ Continuance F Inspecto . <br /> Signature <br /> Suvervisor/Lead Senior COMMENTS:SUPERb'ISOR/LEAD SENIOR Approval: Date: <br /> OA 11 Check Off List: Proofread Report? Correct LAND USE# 7 <br /> Correct CONDITIONS)?_ Logged in LAND USF.Book? <br /> .I I ut,UG Report 47201 �I;rch v <br />