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NOTE., PULL Ak HERMITS (Septic, Well, etc.) MAKI ,'OPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0007942 <br /> DATE RECEIVED by EHD: October 09,2009 APPL#: PA-0900246 <br /> Referral Agency STAFF CONTACT: 'JOHN FUNDERBURG PE : 2690 <br /> LOT LINE ADJUSTMENT(LA) <br /> COMPLETE& SUBMIT BY: ARAP-AY-s <br /> e <br /> Assigned to : EE0005944 ESCOTTO <br /> SITE ADDRESS: 22011 N DE VRIES RD, LODI APN : 01302006 07 <br /> In completing the Land Use investigation, draw ail 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 /> sw <br /> I recommend: Approval Denial Continuance Inspector <br /> Supervisor/Lead Senior COMMENTS: Signature <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> t?A if check(]fiF Lrst a Proa O Reports — arr t LAID F#`. Y <br /> . Lcrrreet � I TQPs�( Loged $ISE Book?, <br /> M <br /> EH 06 06 Report 97201 October 13,2009 <br />