Laserfiche WebLink
NOTE: PULL ALL RMITS (Septic, Well, etc.) MAK! OPIES FOR FILE <br /> LAND USE REPORT RECORDED: SU0004627 <br /> DATE RECEIVED by EHD: September 02,2004 APPL#: PA-04-488 <br /> Referral Agency STAFF CONTACT: KATHY ALLEN PE : 2622 <br /> SUBDIVISON-MINOR(MS) <br /> COMPLETE& SUBMIT BY: Tue, September 21, 2004 <br /> Assigned to : EE0000149 BORGES <br /> SITE ADDRESS: 11456 W ST RT 12 HWY,LODI APN : 02506003 <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 /> VV <br /> I recommend: Approval ❑ Denial El Continuance ❑ Inspector: <br /> Signature <br /> Sunervisor/Lead Senior COMMENTS: <br /> - �/•Q l Giit.C.P.Y i"/ Gln+d a.� L�iw9 ��'N''-a <br /> OS- <br /> 7) Ll 0 3 � <br /> SUPERVISOR/LEAD SENIOR Approval: Date: �(/U <br /> OA 11 Check Off List: Proofread Report? - Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> 1111 06 06 Report#7201 Pace I Scpleniber 02.2004 <br />