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NOTE: PULL AL►-rERMITS (Septic, Well, etc.) MAKE,�-13PIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0007237 <br /> DATE RECEIVED by EHD: June 20,2008 APPL#: PA-0800182 <br /> Referral Agency STAFF CONTACT: JASON JONES PE : 2632 <br /> SITE APPROVAL-GENERAL(SA) <br /> COMPLETE&SUBMIT BY: Wed, July 2, 2008 <br /> Assigned to : EE0005366 MEDINA <br /> SITE ADDRESS: 17048 N LOCUST TREE RD, LODI APN : 0 62&36 <br /> In completing the Land Use investigation, draw all Public Health factors on the exhibit (i.e., sewage disposa , 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: �Yyyyo Public Sewer: � <br /> Name of Purveyor Name of System <br /> awan"fiL7� - _ <br /> (a) 10:08 <br /> �!j) 11:07 Prior to Issuance of Building Permits <br /> e) 22:02 Prior to Issuance of Building Permits <br /> NOTE: The Environmental Health Department(EHD) recognizes that the <br /> domestic water well located on Assessor Parcel Number: 05112063; <br /> currently provides domestic water to Assessor Parcel Number: 05112063 , <br /> This is_an existing nonconforming use. <br /> �D> 11:05 ES2<--� �evt. s<<oxc <br /> (F) 11:03 (a) <br /> (F) 22:04 Delete first sentence, start with should the number..... <br /> 203:02 ? <br /> ` 102:01 <br /> C [ 102:04 <br /> �Z J 102:05 ?is pKo��1rr �j <br /> PERN ISOR/ LEAD SENIOR Approcal: -. ._. Dais " <br /> A 11 Check Off List Proufrcad Report?`: Correct LAND USE f, <br /> (--urr-,ct r't��DlTlu�`(S)'?_� - Logged in LAND L),'F.Book? <br /> EH 06 06 Report#7201 lune 20, <br />