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NOTE: PULL AI.6 .eRMITS (Septic, Well, etc.) MAKE.. PINS FOR FILE <br /> LAND USE REPORT RECORD ID: SU0005306 <br /> DATE RECEIVED by EHD: August 15,2005 APPL#: PA-0500522 <br /> Referral Agency STAFF CONTACT: ANTONIO SALCEDO PE : 2690 <br /> "`� � LOT LINE ADJUSTMENT(LA) <br /> COMPLETE&SUBMIT BY: <br /> Assigned to : EE0004000 VAN DYNE <br /> SITE ADDRESS: 4700 W LOVELY RD, TRACY APN : 25010008 TO 10 <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: �T <br /> rC <br /> 3 <br /> I recommend: Approval n Denial Continuance Inspecto <br /> I 'F- <br /> r <br /> ignatur <br /> Supervisor/Lead Senior OM ENTS: <br /> 11 * 46 <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> OA 11 Check Off List: <br /> Proofread Report? - . "' " "` `'Correct LAND USE#? <br /> Correct CONDITION(S)? ""' Logged in LAND USE Book? <br /> EH 0606 Report#7201 1 21I0U <br />