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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0009347 <br /> DATE RECEIVED by EHD: September 14,2012 APPL#: PA-1200179 <br /> Referral Agency STAFF CONTACT: RICK GRIFFIN PE : 2690 <br /> A <br /> �` `, LOT LINE ADJUSTMENT(LA) <br /> COMPLETE&SUBMIT BY: Y <br /> -- /Jy1 ��� Assigned to: EE0005944 ESCOTTO <br /> SITE ADDRESS: 6671 E HWY 12 ,LODI APN : 04913052 53 <br /> [n 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: FYI-6 a65L'.'4eJ : egc L=61 4� 6 e�cU L>C1. AEEQ�w <br /> /AlC #/ �a 17��S it /2 iiL�t/cE/>/jf1 c SifSd��i7 G 14- <br /> Ab <br /> 4-Ab 44tF K L c-4L L[B_6dd:iZE ZCC 4� <7-- <br /> I <br /> Y=I recommend: Approval Denial ❑ Continuance El Inspector <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> SI1F'ERVISOR/ LEAD SENIOR Approval: Date: <br /> OA II Check Off List: Proofread Rep 1 Correct LAND USE#? <br /> Correct CONDIIJON(S)? Logged in LAND USE Book? <br /> EH 06 06 Report 97201 Septcmbtr 14,201: <br />