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NOTE: PULL ALI,ERMITS (Septic, Well, etc,) MAKL_OPIES FOR FILE <br /> LAND USE REPORT RECORD ID: 500007675 <br /> DATE RECEIVED by EHD: April 13,2009 APPL#: PA-0900007 <br /> Referral Agency STAFF CONTACT: RICK GRIFFIN PE : 2631 <br /> SITE APPROVAL-MINOR(SA) <br /> COMPLETE & SUBMIT BY: Wed, April 29, 2009 <br /> Assigned to : EE0005366 MEDINA <br /> SITE ADDRESS: 19000 N LOWER SACRAMENTO RD,WOODBRIDGE APN : 01524003 <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: � 4ge= Public Sewer: <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: iy�cz <br /> d� <br /> /�j.•Oa <br /> ao.- yy <br /> I recommend: Approval enialEl <br /> Continuance I spec <br /> Stature <br /> Supervisor/Lead Senior COMMENTS: <br /> 5 <br /> �A-) t 0 : 09 <br /> MIPFRVISOR ! LEAD SENIOR Appro%al: J=. _ �� -Date: <br /> OA 11 Check OH List Proofread Report'? Correct LAND USI:i! '? <br /> Correct CONDII'ION(S)'t Logged in LAND IiSB Book? <br /> ED 06 06 Report 97201 ,\pri I I 2o0 <br />