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NOTE: PULL ALL VERMITS (Septic, Well, etc.) MAKE L,31ES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0006571 <br /> DATE RECEIVED by EHD: May 18,2007 APPL#: PA-0700242 <br /> Referral Agency STAFF CONTACT: ANTONIO SALCEDO PE : 2625 <br /> USE PERMIT-MINOR(UP) <br /> COMPLETE&SUBMIT BY: Wed, May 30, 2007 <br /> Assigned to : EE0005366 MEDINA <br /> SITE ADDRESS: 20265 N RAY RD, LODI APN : 01117027 <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 /> I recommend: Approval Denial ❑ Continuance In or: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> / o4 <br /> r j <br /> fJ _ <br /> 2— <br /> Z-5-3 o / <br /> SUPERVISOR/LEAD SENIOR Approval: Date: l <br /> i <br /> EH 06(6 Report#7201 May 18,2007 <br />