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NOTE: PULL ALL w-RMITS (Septic, Well, etc.) MAKE k.-.DIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0006621 <br /> DATE RECEIVED by EHD: July 10,2007 APPL#: PA-0700119 <br /> Referral Agency STAFF CONTACT: JASON JONES PE ; 2631 <br /> SITE APPROVAL-MINOR(SA) <br /> COMPLETE& SUBMIT BY: Tue, August 7, 2007 <br /> Assigned to : EE0005366++I4HN:4- 46-crrcy/'6 <br /> SITE ADDRESS: 13311 N SHATTUCK TRACT RD, LODI APN : 05807029 3132 <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: <br /> I recommend: Approval Denial Continuance F-1 Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> SUPERVISOR/ LEAD SENIOR Approval: Date: <br /> OA 11 Check Off List: Proofread Report? Correct LAND USE#? <br /> Correct CQNDITiON(S)'% Logged in LAND USE I3ooV _ J <br /> -1-106 06 Report#7201 July 10,2007 <br />