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NOTE: PULL ALL"*�RMITS (Septic, Well, etc.) MAKE-wJPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0004824 <br /> DATE RECEIVED by EHD: February 08,2005 APPL#: PA-05-45 <br /> Referral Agency STAFF CONTACT: ANTONIO SALCEDO PE : 2690 <br /> e, t f P I V` `� LOT LINE ADJUSTMENT(LA) <br /> COMPLETE & SUBMIT BY: ;�{ <br /> Assigned to : EE0005944 ESCOTTO <br /> SITE ADDRESS: 6891 S ROBERTS RD, TRACY APN : 16211001 TO 04 <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 /> -1711 <br /> AM 1QW 7L <br /> • � �i�2r�rJL.S��'JZG/.SScf.�3 Gam' ����.cLt��_ <br /> U3 <br /> I recommend: Approval Denial 7 Continuance F-1 Inspector <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> J <br /> 3 ov <br /> SUPERVISOR/LEAD SENIOR Approval: Date: d <br /> OA II Check Off List: Proofread Report? Correct LAND USE#?- <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 Page 5 February 10.200 <br />