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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0009249 <br /> DATE RECEIVED by EHD: June 22,2012 APPL#: PA-1200110 <br /> Referral Agency STAFF CONTACT: N PE : 2690 <br /> LOT LINE ADJUSTMENT(LA) <br /> COMPLETE & SUBMIT BY: <br /> 121 a. <br /> Assigned to: EE0005944 ESCOTTO <br /> SITE ADDRESS: 12122 N TULLY RD,LODI APN: 06504042 46 <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: �)fC � , 2� ��Q Z�6-e5k�(-/_j z/ f�7 !(tom <br /> ft/l�ib2v �1az� <br /> 41 GYo -.c U 4 rL -Ze Z,-ok <br /> I recommend: Approval 12 Denial ❑ Continuance Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> c <br /> . v <br /> l'PF,RVISOR/ LEAD SENIOR Approval: _ Date: IL <br /> OA I/Check ON List. Proofread Report? Correct LAND USE 4 ? <br /> Correct CONDI'rION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 <br /> June 22,2012 <br />