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NOTE: PULL ALL MITS (Septic, Well, etc.) MAKE Cl.,,ES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0006867 <br /> DATE RECEIVED by EHD: December 11,2007 APPL#: PA-0400523 TE <br /> Referral Agency STAFF CONTACT: PATRICK CROSBY PE : 2633 <br /> SITE APPROVAL-MAJOR(SA) <br /> COMPLETE&SUBMIT BY: Wed, January 9, 2008 <br /> Assigned to : EE0004045 TASIOPOULOS <br /> SITE ADDRESS: 11651 E PALM AVE, MANTECA APN : 22809005 <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 /> 1h 0 <br /> twn- <br /> r <br /> I recommend: Approval Denial Continuance El Inspector' <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> SUPERVISOR/LEAD SENIOR Approval: Date: 1 <br /> OA Il Check Off List: `���"Proofread Report? Correct LAND USL#?` <br /> Correct CONDITION(S)? Logged in (,AND USE Book?. <br /> -H 06 06 Report#7201 <br /> December 12,2007 <br />