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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0009807 <br /> DATE RECEIVED by EHD: October 18,201_3 APPL#: PA-1300181 <br /> Referral Agency STAFF CONTACT: MO HATEF PE : 2690 <br /> LOT LINE ADJUSTMENT(LA) <br /> COMPLETE&SUBMIT BY: <br /> Assigned to : EE0005944 ESCOTTO <br /> SITE ADDRESS: 5920 W KINGDON RD, LODI APN : 05514012,05515007& 20 <br /> [n 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 /> 3ensity, location of house, wind direction, etc.... <br /> Public Water: Public Sewer: <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: _G/LE YLCGr/ aV4S Cl/ up GutSZE 1&gft 7F .r 1 Zetel LN!t=— Yr75 <br /> PA2G' / eat74A✓< q eZ4 472464 441< <br /> A)O AencI\ <br /> I recommend: Approval a Denial F] Continuance F Inspec o . <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: 1 I <br /> f2 kpk CM+ <br /> Nn(n C-1a •1 r� <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> i aai �uu.PS h�i iBl' x n t, <br /> EH 06 06 Report 47201 October 21,201' <br />