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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0004988 <br /> DATE RECEIVED by EHD: April 12,2005 APPL#: PA-05-125 <br /> Referral Agency STAFF CONTACT: RAYMOND HOO PE : 2625 <br /> USE PERMI'r-MINOR(UP) <br /> COMPLETE& SUBMIT BY: Wed, April-21, 2005 <br /> Assigned to : ££0005366 MEDINA ; <br /> SITE ADDRESS: 18450 N HWY 99 ,ACAMPO APN : 01709029 <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 /> 4✓ <br /> Al <br /> 41Y,4- AA A10 <br /> s <br /> ® / iSAO <br /> AOawl <br /> /a <br /> I recommend: Approval ❑ Denial Continuance Inspector: <br /> Signature <br /> SuSn e�rviso'r/Lead Senior COMMENTS: <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> OA H Check Off list: Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report 47201 Page 1 ' April 13,2005 <br />