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NOTE: PULL ALL OERMITS (Septic, Well, etc.) MAKE ocPtES FOR FILE <br /> LAND USE REPORT RECORD ID: S00005095 <br /> DATE RECEIVED by EHD: June 15,2005 APPL#: PA-0500329 pp1` <br /> Referral Agency STAFF CONTACT: KATHY ALLEN PE : 2611 <br /> SUBDIVISION-,NIAJOR(SU) 1 1 <br /> COMPLETE & SUBMIT BY: Wed, June 29, 2005 <br /> Assigned to : EE0005366 MEDTNA <br /> SITE ADDRESS: 51-jN$T RT"HWY,ACAMPO APN : 00509058 <br /> In completing the Land Use investigation, draw all Public I Iealth 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: I Public Sewer: <br /> 7��7" rveyo f Purve o Name of System <br /> SUMMARY OR COMMENTS: <br /> i <br /> ' ^ n <br /> � <br /> I recommend: ApprovalIF-1 Denial Continuance ns o <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> A . <br /> D t..� <br /> AX: -Mo-�00 <br /> ad a <br /> SUPERVISOR/ LEAD SENIOR Approval: Date: <br /> OA 11 Check ON List: Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? - Logged in LAND USE Book? <br /> Ell 0606 Report x7201 I1 :0 ('� /_ J2��^ -J June l' 'f <br />