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NOTE: PULL AL,.,ERMITS (Septic, Well, etc.) MAK,,..,,OPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0005777 <br /> DATE RECEIVED by EHD: November 21,2005 APPL#: PA-0500743 <br /> Referral Agency STAFF CONTACT: CEALY LEIN PE : 2690 <br /> Az) <br /> :� LOT LINE ADJUSTMENT(LA)Assigned <br /> & SUBMIT BY Y )�l� .� <br /> Assigned to : EE0004000 VAN DYNE <br /> SITE ADDRESS: 11054 W LARCH RD, TRACY APN : 21217039 <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: Zz l <br /> J/ <br /> L/� <br /> I recommend: Approval 12 Denial ❑ Continuance Inspector: uevlf at, <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> t� <br /> SUPERVISOR/LEAD SENIOR Approval: Date: f d J <br /> ,o <br /> ,.- 3 ,. k ¢9!c•w; .. �.T+''f.�- v € e .sa.t` S,.s:be.✓moi <br /> ! ++rr t <br /> EH 06 06 Report#7201 November 21,2005 <br />