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NOTE: PULL ALL1—ERMITS (Septic, Well, etc.) MAKE w*PIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0003628 <br /> DATE RECEIVED by EHD: May 04,2004 APPL#: PA-03-597 <br /> Referral Agency STAFF CONTACT: JENNIFER JOLLEY PE : 2633 <br /> SITE APPROVAL-MAJOR(SA) <br /> COMPLETE&SUBMIT BY: � , Assigned to : EE0001456 HESS <br /> SITE ADDRESS: 3110 S POCK LN, STOCKTON APN : 17912008 <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: G ' !r , `. Public Sewer: <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: �) / <br /> ' <br /> 411i —no'3 <br /> -/ <br /> / )/t - 0& SSS <br /> I recommend: Approval Denial Continuance Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> �' - <br /> a i <br /> D . IS- 3 :0 ( <br /> a 3 <br /> SUPERVISOR/LEAD SENIOR Approval: ' Date: <br /> OA //Check Off List: Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 I'acc 3 May 10,2004 <br />