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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0004747 <br /> DATE RECEIVED by EHD: December 15,2004 APPL#: PA-04-699(PA) Pre-Application <br /> Referral Agency STAFF CONTACT: KAHTY ALLEN PE ; 2622 <br /> SUBDWISON-MINOR(MS) <br /> COMPLETE&SUBMIT BY: Wed, December 29, 2004 <br /> Assigned to : EE0000321 OLIVEIRA <br /> SITE ADDRESS: 138 N WAGNER AVE, STOCKTON APN : 15902025 <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: (A-) zs — Public Sewer: 'E4 <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: <br /> I <br /> p o o d� _� a. �! 2- <br /> 10 , 02- <br /> zp rvermrw <br /> [ recommend: Approval Denial Continuance Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> SUPERVISOR 1 LEAD SENIOR Approval: Date: J <br /> OA N Check Off List: Proofread Report? (�.- Corrcct LAND USE 4? <br /> Correct CONDI PION(S? Logged in LAND USE Book? <br /> cH 06 06 Report 7201 �� �� \ 3 Pa_c IDeinbr .' <br />