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NOTE: PULL ALL`...RMITS (Septic, Well, etc.) MAKE w4PIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0004625 <br /> DATE RECEIVED by EHD: August 30,2004 APPL#: PA-04-476 <br /> Referral Agency STAFF CONTACT: RAYMOND HOO PE : 2622 <br /> SUBDIVISON-MINOR(MS) <br /> COMPLETE& SUBMIT BY: Tue, September 21, 2004 <br /> Assigned to : EE0005366 MEDINA <br /> SITE ADDRESS: 16848 N TULLY RD, LODI APN : 05303010 <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: 61�1 Public Sewer: <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: <br />/s?"), <br /> S- <br /> _ e T <br /> �S' O o? <br /> I recommend: A�roval Denial Continuance Ins <br /> -/ ?Signature <br /> Supervisor/Lead Senior COMME TS: <br /> 7 <br /> SUPERVISOR/LEAD SENIOR Approval: ` Dater <br /> OA 11 Check Off List: Proofread Report? t.+ Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 I'agc September 02,2004 <br />