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NOTE: PULL ALS ERMITS (Septic, Well, etc.) MAK�OP1ES FOR FILM <br /> LAND USE REPORT RECORD ID: SU0007396 <br /> DATE RECEIVED by ERD: September 29,2008 APPL#: PA-0800283 <br /> Referral Agency STAFF CONTACT: JASON JONES PE : 2690 <br /> _ LOT LINE ADJUSTMENT(LA) <br /> COMPLETE&SUBMIT BY: � Jjl <br /> Assigned to : EE0005366 MEDINA <br /> SITE ADDRESS: 18944 N LOWER SACRAMENTO RD, WOODBRIDGE APN : 01524007 14 <br /> In completing the Land Use investigation, draw all Public Health factors on the exhibit (i.e., sewage disposal, wat <br /> supplies, etc...). Where necessary, on an attached piece of plain paper, draw complete map of area showing population <br /> density, location of hous wind direction, te.... <br /> Public Water:—,,—,,,,,,, <br /> �� '7"�� <br /> p-,_,,„,. Qhj Public Sewer: <br /> Name of Purveyor Name of System <br /> f 1 OR COMMENTS: <br /> 06 <br /> NOTE: <br /> The Environmental Health Department recognizes that the domestic water well located <br /> on Parcel #2 provides a domestic water source for the Singe Family Residence <br /> located on Parcel # 1. This is an existing nonconforming condition. <br /> i9 <br /> commend: Approval Denial Continu _ e nspector <br /> Sio ature <br /> _ ervisor/Lead Senior COMMENTS: <br /> nbA <br /> SUPERVISOR/ LEAD SENIOR Approval: C Ilatr. i <br /> OA 11 Check Off List: Proofread RepmT' Correct LAND i.ISE#:? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 ,,.., ip - <br />