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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0009367 <br /> DATE RECEIVED by EHD: October 01,2012 APPL#: PA-1100031 TE <br /> Referral Agency STAFF CONTACT: RICK GRIFFIN PE : 2631 <br /> SITE APPROVAL-MINOR(SA) <br /> COMPLETE&SUBMIT BY: Tue, October 16, 2012 <br /> Assigned to : EE0004045 TASIOPOOLOS <br /> SITE ADDRESS: 15405 S SEXTON RD, ESCALON APN : 20524024 <br /> [n 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 /> 3ensity, location of house, winddirection, etc.... <br /> Public Water: Public Sewer: f <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: <br /> I recommend: Approval 0 Denial ❑ Continuance ❑ Inspe "— <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> ')-40 t) <br /> SUPERVISOR/LEAD SENIOR Approval: <br /> OA 11 Check ON List: Proofread Report? _ Correct LAND USE 4? , <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> 106 06 Report 97201 <br /> Octohcr U I_'J"I_ <br />