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"IN <br /> A A S c__ RT i <br /> if- <br /> NOTE: PULL ALL.,.,�RMITS (Septic, Well, etc.) MAKE�-0P� Si.FQ F,L4h �l 1 ` ' t <br /> LAN© USE REPORT RECORD ID: SU0007462 <br /> DATE RECEIVED by EHD: September 24,2008 APPL#: PA-0800259 REV SP <br /> Referral Agency STAFF CONTACT: CORINNE KING PE : 2625 <br /> USE PERMIT-MINOR(UP) <br /> COMPLETE & SUBMIT BY: Wed, October 8, 2008 <br /> Assigned to: EE0005366 MEDINA <br /> SITE ADDRESS: 12828 N LOWER SACRAMENTO RD,LODI APN : 05807023 <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: <br /> 04 <br /> 11:07 Prior to issuance of building permits <br /> 11:03 (a) <br /> 22:04- <br /> --`22:05 22:05 (a) <br /> - -22:03 add "pit well" after abandoned <br /> 2:07 <br /> I' <br /> 203:02 <br /> I recommend: Approval Denial F-1 Continuance Inspec r: <br /> Signatur <br /> Supervisor/Lead Senior COMMENTS: <br /> ., - itS CQ <br /> ( 2 ` o A- _ <br /> SUPERVISOR/LEAD SENIOR Approval: Date: , <br /> Po ad R o - = <br /> OA <br /> �►aecrc ��r ,s W. �' , + Lt ... <br /> w_ _ Oorrect CONDI V o D Usrc�k t <br /> L 99 <br /> =- <br /> EH 06 06 Report 47201 September 29,2008 <br />