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r NOTE: PULL ALL MITS (Septic, Well, etc.) MAKE �JIES FOR PILE <br /> LAND USE REPORT RECORD ID: SU0006512 <br /> DATE RECEIVED by EHD: April 10,2007 APPL#: PA-0700145 <br /> Referral Agency STAFF CONTACT: JASON JONES PE : 2690 <br /> LOT LINE ADJUSTMENT(LA) <br /> COMPLETE&SUBMIT BY: A R RY1 <br /> 8 S%01 so how I � Assigned to : EE0007379 �8ISR33'EN •ES� <br /> SITE ADDRESS: 10950 E HWY 12 , LODI APN : 05114005 <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- .� <br /> 2C-� - �t �/� C7�/r '-��J>' Ye� a� + dam✓ / �'ri �e_ / <br /> - <br /> I recommend: Approval Denial Continuance Inspector <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> SUPERVISOR/LEAD SENIOR Approval: Date: 8 <br /> OA If Check Off Lrsf.;r <br /> Proofread JteporE7 correct LAND USE#7 , <br /> Correct CONDITIONS) ` :: Lpgged m I.A�iD USE Bo <br /> EH 06 06 Report#7201 April 11,2007 <br />