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a <br /> NOTE: PULL ALL P19RMITS (Septic, Well, etc.) MAKE�.—!PIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0004593 <br /> DATE RECEIVED by EHD: August 04,2004 APPL##: SU-00-01 (TE) <br /> Referral Agency STAFF CONTACT: JENNIFER JOLLEY PE : 2611 <br /> SUBDIVISION-MAJOR(SU) <br /> COMPLETE& SUBMIT BY: Wed, August 11, 2004 <br /> Assigned to : EE0000149 BORGES <br /> SITE ADDRESS: 13751 E BRANDT RD,LODI APN : 01906029 <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 ❑ Denial ❑ Continuance F-1 Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> SUPERVISOR I LEAD SENIOR Approval: Date: <br /> OA 11 CheCk Off Llst: Proofread Report? CorrecC.- <br /> ComeONDITTUN(S .?XIMF <br /> Logged�iny AND US 13ook1 <br /> EH 06 06 Report 47201 Page 2 August 06,2004 <br />