Laserfiche WebLink
NOTE: PULL ALL �RMITS (Septic, Well, etc.) IY1:AjjZ)IES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0008023 <br /> DATE RECEIVED by EHD: December 34,2009 APPL#: PA-0900294 <br /> Referral Agency STAFF CONTACT: JOHN FUNDERBURG PIE. 2690 <br /> LOT LINE ADJUSTMENT(LA) <br /> COMPLETE&SUBMIT BY: <br /> Assigned to : EE0005366 MEDINA <br /> SITE ADDRESS: - 11769 N HWY 99 W FRTG RD, LODI APN : 05910010 <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: v public Sewer: - <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: <br /> 11 Q <br /> 11:10 Submit a revised site plan or map to the Environmental Health Department <br /> showing sewage and well information that clearly delineates the sewage disposal <br /> location as required by ordinance requirements ( San .......... <br /> NOTE: 201:02 <br /> Applicant shall have the seepage pits and leach lines to the existing septic system <br /> (installed under permit # 84-655)uncovered to verify that the seepage pits and leach <br /> lines meet the required distance to the new property line according to the .......... <br /> - -- - - -- . - - - - — — -- <br /> Sig gature Y <br /> Supervisor/Lead Senior COMMENTS: <br /> O v-e a Q11270- <br /> IV Ile -- <br /> SUPERVISOR/LEAD SENIOR Approval: Date: Z-( <br /> OA It Check Off List; Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(5)? Logged in LAND USE Book? <br /> EH 06 06 Report 47201 December 14,2009 <br />