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NOTE: PULL ALL 6—AMITS (Septic, Well, etc.) MAKE `,PIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0004722 <br /> DATE RECEIVED by EHD: November 23,2004 APPL#: PA-04-693 <br /> Referral Agency STAFF CONTACT: KATHY ALLEN PE : 2631 <br /> SITE APPROVAL-MINOR(SA) <br /> COMPLETE& SUBMIT BY: Tue, December 7, 2004 <br /> Assigned to : EE0001456 HESS <br /> SITE ADDRESS: 30400 E LONE TREE RD, OAKDALE APN : 22914011 <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: �dlJ111 P Public Sewer: <br /> Name of Purveyor Name of System' <br /> SUMMARY OR COMMENTS: <br /> . 11A <br /> I recommend: Approval 0- Denial ElContinuance Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> Z .Q <br /> J — <br /> r ✓3 IL <br /> • 1 � <br /> • a <br /> SUPERVISOR/ LEAD SENIOR Approval: Date: y <br /> OA 11 Check Off List: Proofread Report? .. Correct LAND USE#? <br /> Correct CONDITION(S)? • -- Logged4n LAND USE Book? <br /> I I I P6 06 Repon 87201 Page 8 November 24,2004 <br />