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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0004911 <br /> DATE RECEIVED by EHD: March 15,2005 APPL#: PA-04-796 <br /> Referral Agency STAFF CONTACT: GILLIAN HAYES PE : 2631 <br /> SrrE APPROVAL-MINOR(SA) <br /> COMPLETE&SUBMIT BY: Tue, April 5, 2005 <br /> Assigned to : EE0004000 VAN DYNE <br /> SITE ADDRESS: 3723 S ST RT 99 , STOCKTON APN : 17915027 <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: 01/y Public Sewer: Aft) <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: <br /> 1 recommend: Approval Denial Continuance El Inspector: 41t- <br /> Signature <br /> Su ervisor/Lead Senior COMMENTS: <br /> .Q <br /> rr <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> OA 11 Check OH List: Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 Page 1 March 17,2005 <br />