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NOTE: PULL AL ERMITS (Septic, Well, etc.) MAK. OPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0007635 <br /> DATE RECEIVED by EHD: March 13,2009 APPL#: PA-0800322 <br /> Referral Agency STAFF CONTACT: KEVIN SWANSON PE: 2622 <br /> SUBDIVISON-MINOR(MS) <br /> COMPLETE&SUBMIT BY: Tue, April 7, 2009 <br /> Assigned to : EE0005366 MEDINA <br /> SITE ADDRESS: 5601 W PELTIER RD, LODI APN: 00304012 <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: bio Public Sewer: <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: <br /> - ," <br /> oy <br /> aa�. O S�aa G:3c..P <br /> ,recommend: Approval Denial ContinuanceEl ector: d 'h <br /> I igna[ure <br /> uoervisor/Lead Senior COMMENTS: <br /> L <br /> 0 .rj�> <br /> VV <br /> e, Tr. <br /> ! 03 Q <br /> RVISOR LEAD SENIOR Approval• Date: q <br /> CCheck Off List: Proofread Report? - Corrept_LAND USE ti ? <br /> �'- Correct CONDITION(S) ! Logged i D USE,Book? <br /> Report#7201 March 16,2009 <br />