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G� <br /> NOTE: PULL ALL PERA&S (SEPTIC, WELL, ETC...) AME COPIES FOR FILE <br /> LAND USE REPORT APP#: PA-04-44 S <br /> EHD RECEIVED APP.REFERRAL: 2/10/04 COMPLETE & SUBMIT BY: 2-27-04 <br /> DATE DATE <br /> ATTN: JENNIFER JOLLEY <br /> SITE ADDRESS: 24951 NORTH SOWLES ROAD, ACAMPO <br /> In completing the Land Use investigation, draw all Public Health factors on the exhibit(i.e.: sewage disposal, <br /> water supplies, etc...). Where necessary, on an attached piece of plain paper, draw a completed map of area <br /> showing population density, location of house, wind direction, etc.... <br /> Public water: Public sewage: <br /> SUMMARY OR COMMENTS: <br /> I recommend: Approval Denial Continuance Inspector's Signature 1 <br /> Supervisor/Lead Senior Comments: <br /> —Dao 3 <br /> �- as .a � ✓ ✓ <br /> • - mss . . <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> F. 1063 , � <br /> EH 06 06 Rev 1/99 F '1 S �Q 1 <br /> . <br />