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NOTE: PULL ALLRMITS (Septic, Well, etc.) MAKEIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0005837 <br /> DATE RECEIVED by EHD: December 20,2005 APPL#: PA-0500829 <br /> Referral Agency STAFF CONTACT: MO HATEF PE : 2622 <br /> SUBDIVISON-MINOR(MS) <br /> COMPLETE& SUBMIT BY: Tue, January 3, 2006 <br /> Assigned to : EE0004000 VAN GYNE <br /> SITE ADDRESS: 16411 S VICTORY RD, OAKDALE APN : 22922030 <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 /> I recommend: Approval IA Denial El Continuance Inspector: <br /> Signatur� <br /> Supervisor/Lead Senior COMMENTS. <br /> Qurt (n w4 s2 <br /> r Br <br /> Ut <br /> SUPERVISOR/LEAD SENIOR Approval: -- Date: <br /> OA H Check Off List. Proofread Report? Correct LAND USE#? " <br /> Correct CONDITION(S)'?-" Logged in LAND USE Book?,, <br /> E <br /> EH 06 06 Report 47201 December 21,2005 <br />