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NOTE: PULL ALLuRMITS (Septic, Well, etc.) MAKE SPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0004484 <br /> DATE RECEIVED by EHD: May 20,2004 APPL#: PA-04-251 Pre-Application <br /> Referral Agency STAFF CONTACT: JENNIFER JOLLEY PE : 2611 <br /> SUBDIVISION-MAJOR(SU) <br /> COMPLETE& SUBMIT BY: Wed, June 9, 2004 Assigned to : EE0005366 MEDINA <br /> SITE ADDRESS: 9422 E JAHANT RD, ACAMPO APN : 00734009 <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: n R Public Sewer: tQ <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: <br /> d� <br /> -1 07 <br /> as �� <br /> as oa n J <br /> aaoo X� <br /> I recommend: Approval Denial Continuance Inspec <br /> ignature(/'( <br /> Supervisor/Lead Senior COMMENTS: <br /> 01 <br /> Ila A <br /> SUPERVISOR/ LEAD SENIORApproval: jK-- Date: <br /> OA It Check Off List:, Proofread Report? - 'Correct LAND USE#`? - <br /> Correct CONDITION(S)?- Logged in LAND USE Book? <br /> EH 06 06 Report 47201 Page 8 May 24,2004 <br />