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NOTE: PULL AL'1L ERMITS (Septic, Well, etc.) MAKE,dOPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0007859 <br /> DATE RECEIVED by EHD: August 06,2009 APPL#: PA-0800019 TE <br /> Referral Agency STAFF CONTACT: JOHN FUNDERBURG PE : 2690 <br /> LOT LINE ADJUSTMENT(LA) <br /> COMPLETE& SUBMIT BY, Tue, August 11, 2009 <br /> Assigned to : EE0005366 MEDINA <br /> SITE ADDRESS: 11082 E HWY 12 ,LODI APN : 05114007 <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 Systein <br /> SUMMARY OR COMMENTS: <br /> l <br /> i <br /> I recommend: Approval D--DCKi­a1 F-1 Continuance Inspector-:--'- <br /> nspector: <br /> S_upervi.sor/Lead Senior COMMENTS: Signtore <br /> i <br /> SUPERVISOR/LEAD SENIOR Approval: <br /> OA 1 Chet off List Px nfi�eaJ�oxt s D T1 E $ <br /> oi►eetI3ITIDI�T � Lb 'in LAND t13 <br /> EH 06 06 Report#7201 August 10,2009 <br />