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NOTE: PULL ALI.,ERMITS (Septic, Well, etc.) MAKt._ .PIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0005781 <br /> DATE RECEIVED by EHD: November 21,2005 APPL#: PA-0500761 <br /> Referral Agency STAFF CONTACT: RICK GRIFFIN PE : 2622 <br /> SUBDIVISON-MINOR(MS) <br /> COMPLETE&SUBMIT BY: Tue, December 6, 2005 <br /> Assigned to : EE0004000 VAN DYNE <br /> SITE ADDRESS: 17201 S SEIDNER AVE, ESCALON APN : 22916015 <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: 0[z <br /> 72 0* <br /> X9 , 05 Aa ADPKOY6L tKEQdiKFe 6Aj <br /> SOON�iA1�i 'fdBE Tv �tE�E/U! (l)�.trs'/rrlur <br /> ®F THS rAyu vy 11/Aitle, <br /> I recommend: Approval Denial Continuance Inspector: 4L 14 <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> l III 01P <br /> D on <br /> 22 •. c9 I d:s <br /> G� :d <br /> 1-7 <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> n <br /> ,t <br /> EH 06 06 Report#7201 - November 21,2005 <br />