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SU0003630
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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2600 - Land Use Program
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LA-01-79
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SU0003630
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Entry Properties
Last modified
5/7/2020 11:30:06 AM
Creation date
9/9/2019 10:11:58 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0003630
PE
2690
FACILITY_NAME
LA-01-79
STREET_NUMBER
22251
Direction
N
STREET_NAME
SECOND
STREET_TYPE
ST
City
CLEMENTS
ENTERED_DATE
5/7/2004 12:00:00 AM
SITE_LOCATION
22251 N SECOND ST
RECEIVED_DATE
10/30/2001 12:00:00 AM
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\S\SECOND\22251\LA-01-79\SU0003630\APPL.PDF \MIGRATIONS\S\SECOND\22251\LA-01-79\SU0003630\CDD OK.PDF \MIGRATIONS\S\SECOND\22251\LA-01-79\SU0003630\EH COND.PDF \MIGRATIONS\S\SECOND\22251\LA-01-79\SU0003630\EH PERM.PDF
Tags
EHD - Public
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NOTE: PULL ALL PERN'� -e'S (SEPTIC, WELL, ETC...) _,XE COPIES FOR FILE <br /> LAND USE REPORT APP# OV <br /> EIID RECEIVED APP.REFERRAL: f COMPLETE & SUBMIT BY A P. IFS�( / <br /> DAT <br /> ATTN: �C <br /> SITE ADDRESS: a a oL S PC <br /> In completing the Land Use investigation, draw all Public Health factor on the exhibit (i.e.: sewage disposal, <br /> water supplies, etc...). Where necessary, on an attached piece of plain paper, draw completed map of area <br /> showing population density, location of house, wind direction, etc.... <br /> Public water: Public sewage: <br /> SUMMARY OR COMMENTS: <br /> t / ' <br /> t , <br /> -7- <br /> fZ� I <br /> a <br /> I recommend: Approval Denial Continuance Inspector's Signdture'- ' <br /> Supervisor/Lead Senior Comments: <br /> / ! <br /> -• - ,dote s- ' <br /> n <br /> Wt <br /> L4+1 <br /> 0'L <br /> .ff <br /> SUPERVISOR/LEAD SENIOR APPROVAL: >, <br /> OA II CHECK OFF LIST. Proofread report? Correct LAND USE#? <br /> EFI 06 06 Rev 1/99 Correct CONDITION(S)? Logged in LAND USE BOOK? <br />
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