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NOTE: PULL ALL-.,dRMITS (Septic, Well, etc.) MAKE..JPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0004669 <br /> DATE RECEIVED by EHD: October 18,2004 APPL#: PA-04-590 <br /> Referral Agency STAFF CONTACT: JENNIFER JOLLEY PE : 2631 <br /> (WIPA SITE APPROVAL-MINOR(SA) <br /> COMPLETE& SUBMIT BY: <br /> Assigned to : EE0005944 ESCOTTO <br /> SITE ADDRESS: 29488 E NORTON AVE, ESCALON APN : 22913046 <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 /> wo 2tzcw-S 4z4E Aa ww/Cabe-zran 52t- <br /> /z4�s� <br /> �1�r32z9 �•�SLSEd L�QE3ie3a��l�7S /-�Go14��G �3/e ' ,E % �o Le aC.SBrTic <br /> I recommend: Approval Denial ❑ Continuance ❑ Inspector: _ <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> w. <br /> w <br /> Q <br /> SUPERVISOR/LEAD SENIOR Approval: '` Date: y <br /> OA 11 Check Off List: Proofread Report? VCorrect LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 Page 9 October 22,2004 <br />