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F e � <br /> e �+ <br /> NOTE: PULL ALL %,. ,AMITS (Septic, Well, etc.) MAKE t;,:PsIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0006264 <br /> DATE RECEIVED by EHD: September 19,2006 APPL#: PA-0600496 <br /> i Referral Agency STAFF CONTACT: KEVIN SWANSON PE : 2690 <br /> LOT LINE ADJUSTMENT(LA) <br /> COMPLETE& SUBMIT BY: F-bY:— Assigned to : EE0005366 MEDINA <br /> SITE ADDRESS: 2609 W SARGENT RD, LODI APN : 02516033 54 59 <br /> I <br /> In completing the Land Use investigation, draw all Public Health factors on the exhib' i. s auawater <br /> supplies, etc...). Where necessary, on an attached piece of plain paper, dra o ple - a, ulation <br /> density, location of house, wind direction, etc.... <br /> Public Water: Public Sewer: <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: -71 <br /> T <br /> LI � I • -' '�F 6+ g <br /> I recommend: Approv Denial Continuance ctor. 4� <br /> Si natur ��� <br /> L e�� l ..P Au� v c••assoscd �r <br /> Supervisor/Lead Senior COMMENTS: Z �avta( t � ,.,gip ,Q �� to" <br /> ., ,1�. <br /> 4a -eL; Q&*— <br /> SUPERVISOR/LEAD SENIOR Approval: Date: 2Z Z� <br /> �Ai4tll°C' ckAff.Llst �' Pr0xead''l3eo7 • .zrtI11,i�SE#? s <br /> 'K ,a �:, � •�',"' Correct C91V1�1T1OI�i�B)? � � #.q '` .. g e i ,�,�JSE�ook"� <br /> EH 06 06 Report 97201 September 19,2006 <br />