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'TIOT-E: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0009476 <br /> DATE RECEIVED by EHD: January 10,2013 APPL#: PA-1200192 <br /> Referral Agency STAFF CONTACT: MO HATEF PE : 2632 <br /> SITE APPROVAL-GENERAL(SA) <br /> COMPLETE&SUBMIT BY: Wed, January 16, 2013 <br /> Assigned to: EE0005944 ESCOTTO <br /> SITE ADDRESS: 23623 N DE VRIES RD, LODI APN: 00304003 <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 /> AI DS AG1 cep, ✓zz"4e-- wiz&&z �i7.s��9S s?¢Zt7� i.✓7lsr/ 3��r <br /> �<G5b Z- 2012- <br /> 1 recommend: Approval [a Denial El Continuance ❑ Inspecto . <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> OA 11 Check Off List: Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 <br /> January 11,201; <br />