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NOTE: PULL ALL k—AMITS (Septic, Well, etc.) MAKE k,-.PIES FOR FILE <br /> LdND USE REPORT RECORD ID: 500004600 <br /> DATE RECEIVED by EHD: August 05,2004 APPL#: PA-04-381 <br /> Referral Agency STAFF CONTACT: GILLIAN HAYES PE : 2631 <br /> SITE APPROVAL-MINOR(SA) <br /> COMPLETE& SUBMIT BY: Wed, September 8, 2004 <br /> Assigned to : EE0005944 ESCOTTO <br /> SITE ADDRESS: 3851 N NEWTON RD, STOCKTON APN : 13207008 <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 /> �/L4'/Cc�Z -�S� �/{2dl'<S CE/�?�x/i`/B��IS� li�G/1FY/roGfPS$�3+a✓ <br /> jL9'<.5�7 Z 3 'GJ�z?fGcGc�/h'-I`llllilf� 6� �Z /� <br /> 511071C 42e%) camW--W ZtuJ qz < cam/ ✓c � «i<GFsc�nro %c <br /> fiGrGr?rn. <br /> I recommend: Approval Denial Continuance ❑ Inspector: _ <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> SUPERVISOR/LEAD SENIOR Approval: Date: 7 J <br /> C4rrect.LA USE#? f <br /> ,�.. Lagyeii'in LAND ttSE Book?, <br /> EH 06 06 Repan 47201 Page 7 August 06,2004 <br />