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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0010933 <br /> DATE RECEIVED by EHD: June 06,2016 APPL#: PA-1600123 <br /> Referral Agency STAFF CONTACT: MO HATEF PE : 2660 <br /> DEVIATION(DV) <br /> COMPLETE& SUBMIT BY: Tue, June 21, 2016 Assigned to: EE0005944 ESCOTTO <br /> SITE ADDRESS: 11209 N HWY 99 /W FRONTAGE RD, LODI APN: 05914063 <br /> In completing the Land Use investigation, draw all Public Health factors on the exhibit(i.e., sewage disposal, water supl <br /> etc...). Where necessary, on an attached piece of plain paper, draw complete map of area showing population density, lot <br /> of house, wind direction, etc.... <br /> Public Water: Public Sewer: <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: <br /> -y1/_sr�c sifS�azc�„/ l�itg/gel <br /> 2y� 4ff3 Ui7 CenJ.J1/lc tol�r/AcLsr c.✓ZH1s A9x IC F � <br /> I recommend: Approval Denial Continuance ❑ InspectoaA <br /> . <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> nb <br /> SUPERVISOR/LEAD SENIOR Approval: Date: (ol('(• ��.� <br /> OA 11 Check Off List: Proofread Report? Correct LAND USE 8? <br /> Correct CONDITION(S)7 Logged in LAND USE Rook? <br /> ER 06 06 Report#7201 1une 06.1n 16 <br />