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NOTE: PULL Ae-,&—.ERMITS (Septic, Well, etc.) MAKL.,�PIES FOR FILE <br /> LAND USE REPORT RECORD ID: S00005248 <br /> DATE RECEIVED by EHD: July 25,2005 APPL#: PA-0500451 <br /> Referral Agency STAFF CONTACT: RICK GRIFFIN PE : 2631 <br /> COMPLETE&SUBMIT BY: <br /> / � SITE APPROVAL-MINOR(SA) <br /> � �_ <br /> Assigned to : EE0004000 VAN DYNE <br /> SITE ADDRESS: 13771 S PRESCOTT RD, MANTECA APN : 2060804 <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 /> 22, 3 e,) <br /> A6 <br /> N/-t 04 7,/a/J <br /> F <br /> [ recommend: Approval Denial Continuance Inspector: <br /> Signature , <br /> Supervisor/Lead Senior COMMENTS: <br /> .o <br /> RVISOR/LEAD SENIOR Approval: Date: <br /> Check Off List: Proofread Report'? Correct LAND USE#? <br /> Correct CONDITION(S)') Logzed in LAND USE Book'? <br /> July 26. 1' <br />