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NOTE: PULL ALL ERMITS (Septic, Well, etc.) MAKE PIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0005596 <br /> DATE RECEIVED by EHD: September 06,2005 APPL#: PA-0500580 <br /> Referral Agency STAFF CONTACT: KARLA KUHL PE : 2622 <br /> SUBDIVISON-MINOR(MS) <br /> COMPLETE&SUBMIT BY: Tue, September 20, 2005 <br /> Assigned to : EE0005366 MEDINA <br /> SITE ADDRESS: 651 W SARGENT RD,LODI APN : 02902057 <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 /> Nares of Purveyor Name of System <br /> SUMMARY OR COMMENTS: <br /> ; y <br /> �_:�?•'�- �S�//tom- -`'''t./'i�.� r-r�--ItP// �'�..iy3`,��9p-Jhr�f��;'" 77L^ �.Ye� � �/C1-"lkrJ-7/,� i..t.r�y?'S��- <br /> I recommend: Approval /t-i Denial Continuance Inspe or: <br /> Sign ture <br /> Supervisor/Lead Senior COMMENTS: <br /> L <br /> 12 <br /> r <br /> f/' ,63 cl <br /> SUPERVISOR/LEAD SENIOR Approval:% C Date: F% <br /> OA 11 Check Off List: Proofread Ite o Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 September 08,2005 <br />