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NOTE: PULL ALL,,, .RMITS (Septic, Well, etc.) MAKE WOWS FOR FILE <br /> LAND USE REPORT RECORD ID: SU0005628 <br /> DATE RECEIVED by EHD: September 13,2005 APPL#: PA-0500329 <br /> Referral Agency STAFF CONTACT: KATHY ALLEN PE : 2611 <br /> n �] tl� SUBDIVISION-MAJOR(SU) <br /> COMPLETE&SUBMIT BY: A S A_I�rrl"S . j�$ <br /> r/ Assigned to : EE0005366 MEDINA <br /> SITE ADDRESS: 26851 N HWY 99 E FR RD,ACAMPO APN : 00509058 <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: o Public Sewer: �»CSnn <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: <br /> I recommend: Approval Denial Continuance In �Q <br /> ignature <br /> Supervisor/Lead Senior COMMENTS: <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> EH 06 06 Report#7201 September 15,2005 <br />