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NOTE: PULL ALLftwERMITS (Septic, Well, etc.) MAKlr-40P1ES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0004992 <br /> DATE RECEIVED by EIID: April 19,2005 APPL#: PA-05-198 <br /> Referral Agency STAFF CONTACT: a •�N,"w PE : 2690 <br /> ,. - l; -. ir'- I .Y j LOT LINE ADJUSTMENT(LA) <br /> COMPLETE&SUBMIT BY: _ <br /> Assigned to : EE0004000 VAN DYNE <br /> SITE ADDRESS: 18424 E LOUISE AVE, ESCALON APN : 20507035 <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: �flf' <br /> nrr <br /> I recommend: Approval El Denial El Continuance Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> ryry <br /> SUPERVISOR/LEAD SENIOR Approval: Date: l 'u <br /> OA l/Check Off List: Proofread Report? Correa LAND USE#? r <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report 47201 Page 2 April 21,2005 <br />