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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0010758 <br /> DATE RECEIVED by EHD: January 22,2016 APPL#: PA-1600001 <br /> Referral Agency STAFF CONTACT: RICK GRIFFIN PE : 2690 <br /> ��"" LOT LINE ADJUSTMENT(LA) <br /> C �E �S>�BY: Fri, January 29, 2016 <br /> JJ 1Fr+ Assigned to : EE0005944 ESCOTTO <br /> SITE ADDRESS: 25 SARGENT RD, LODI (ZS 1 APN : 02516041 <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 /> /�.�rr�� �/ c�sTs �c/r�ui ciT �..✓.l�/� �ibco <br /> 42 <br /> ' l� frz �1i U•J7ili.�5 .9 T1�SfL��1c°�lrliJr/fh�li�Tlis��7 .r>L tel'-?�IYr✓ <br /> ;ra'Jai.Y�Gd2—L�iiz�,r��rr� c��r7�.✓Gc�.cvrr�7 <br /> ,�) lXo- 7"�= afi� trYS .�ocraOliZ�s l ina�s���iZ�rs.aY�Glr.4-z� <br /> I recommend: Approval Denial ❑ Continuance Inspecto7"��Signature <br /> Supervisor/Lead Senior COMMEALTS: <br /> SUPERVISOR/LEAD SENIOR Approval: c Date: <br /> Cat <br /> OA 11 Check Off List: Prooiread Report? Correct LAND USE#? <br /> Correct CONDITION(S? Logged in LAND USE Boob? _ <br /> EH 06 06 Report 47201 January 22,2016 <br />