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NOTE: PULL ALL-PERMITS (Septic, Well, etc.) MAKE-t,:6PIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0005059 <br /> DATE RECEIVED by EHD: May 24,2005 APPL#: PA-0500222 <br /> Referral Agency STAFF CONTACT: GILLIAN HAYES PE : 2656 <br /> REVISIONS TO ACTIONS (RA) <br /> COMPLETE&SUBMIT BY: Wed, June 1, 2005 <br /> Assigned to : EEQ000149 BORGES <br /> SITE ADDRESS: 2823 E MUNFORD AVE, STOCKTON APN : 17910014 <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 /> [ <br /> recommend: Approval ❑ Denial F] Continuance � Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> Fe,x <br /> »« ,a , �' ke.�ws >'3 3 a�Eg++yr-��._ ..____ fr?_a�,�a° <br /> EH 06 06 Report#7202 May 26,2005 <br />