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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE C ]PIES FOR FILE <br /> LAND USE REPORT RECORD ID,. SU0008721 <br /> DATE RECEIVED by EHD: April 20,2011 APPL#: PA-1100061 v <br /> Referral Agency STAFF CONTACT: JOHN FUNDERBURG PE : 2690 <br /> : <br /> 3 LOT LINE ADJUSTMENT(LA) <br /> COMPLETE& SUBMIT BY <br /> Assigned to: EE0005944 ESCOTTO <br /> SITE ADDRESS: 2584 W HWY 4 , STOCKTON APN : 16215002 <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 /> [ recommend: Approval Denial Continuance Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> SUPERVISOR I LEAD SENIOR Approval: Date: L I <br /> e::. krc� read Reort7 � � �Gc3rxect L`AN13 t7SI ?' '.! 3. <br /> '0x411 Check Qi`fl�sf a <br /> r <br /> . +�..°.°�t ,� ,: ,.;•� `Fehr -z, .,y. � &sem&€. "�a;, : ��, �:- <br /> `•.,=s xr. � -:�. --.�r�r,�' .. . .x ,»,. "':: . 6.>'1.i+:"`�: .r��ss!�4�°°.'s,.. ..^�< - 'ss8l�.. r.3{ .".' <br /> �.; intorr8et SON I I IC�Nj ..:, @ fedi t t1N1?LF I3tafllt 1 <br /> .. .. ...... <br /> EH 06 06 Report 47201 April 21,201 1 <br />