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a <br /> NOTE: PULL AU-r-ERMITS (Septic, Well, etc.) MAKL,, *PIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0005113 <br /> DATE RECEIVED by EHD: June 20,2005 APPL#: PA-0500354 <br /> Referral Agency STAFF CONTACT: { F PE : 2690 <br /> LOT LINE ADJUSTMENT(LA) <br /> COMPLETE & SUBMIT 13 v (Q� <br /> ,. Assigned to : EE0004000 VAN DYNE <br /> SITE ADDRESS: 14222 E LOUISE AVE, RIPON APN : 20307035& 36 <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: n/ Public Sewer: A/Q <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: <br /> I recommend: Approval X❑ Denial Continuance ❑ Inspector: <br /> Signature Q <br /> Supervisor/Lead Senior COMMENTS: <br /> SUPERVISOR/ LEAD SENIOR Approval: Date: <br /> Proofread Report? CarrectLAND USE# ` <br /> OA !!Check Off List: A <br /> Correct CONDITIONS}? Logged in LAND USE-Book?,,, <br /> EH 06 06 Report U7201 June 20,2005 <br />