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NOTE: PULL AL1,,,_,.ERMITS (Septic, Well, etc.) MAKE. pIES FOR FILE <br /> LAND USE REPORT RECORD 1D: SU0008786 <br /> DATE RECEIVED by MAD: ,lune 14,2011 APPL#: PA-1100100 <br /> Referral Agency STAFF CONTACT: MO HATEF PE : 2694 <br /> LOT LINE ADJUSTMENT(LA) <br /> COMPLETE& SUBMIT BY: ASARR <br /> - Assigned to : EE0005944 ESCOTTO <br /> SITE ADDRESS: 11130 N HWY 99 , LODI APN : 05926058 <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: _ 0 <br /> �zo s � - zzz al kioft zeyiel 7 r-5 1"-&� G S <br /> 0 Cad !- 5 et ,f- 1. <br /> R;;v2&.;7.Alf yGC.e /�7� � <br /> < . <br /> [ recommend: Approval Denial Continuance Inspecto <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> SUPERVISOR/LEAD SENIOR Approval: Date: �/ 14 <br /> OA Il Check Off L1st �ronfred Report �� ,. Correct I ANq USE94 <br /> rm..,... .: . -S¢a .,.;i -¢ __ :..:y. .. °.¢ ;.sfs ..,e -.�`.. v .,�,. Fl.. -.,�5 .»�a.s. <br /> _ .,. x.,,5:q: brrGGl;�:�N�l`1�_IQkv �J;�,.a 'a.�v..,e .. ¢°`^ € <br /> NIS a ' ¢ <br /> � ,e: .. . ? _ .. aahpggedinlI�DU > Rook � � .. <br /> „ PRI _j <br /> EH 06 06 Report 07201 <br /> June 14,20 i 1 <br />