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NOTE: PULL ALL,,,IRMITS (Septic, Well, etc.) MAKE `JPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0004700 <br /> DATE RECEIVED by EHD: November 15,2004 APPL#: PA-04-622 <br /> Referral Agency STAFF CONTACT: KATHY ALLEN PE : 2631 <br /> SITE APPROVAL-MINOR(SA) <br /> COMPLETE& SUBMIT BY: Tue, December 7, 2004 <br /> Assigned to : EE0001456 HESS <br /> SITE ADDRESS: 10476 W LINNE RD,TRACY APN : 25312030 <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 P6rveyor Name of System <br /> SUMMARY OR COMMENTS: <br /> KJ— <br /> A` <br /> I recommend: Approval Denial Continuance ❑ Inspector: i w <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> orn <br /> 92 se <br /> 1 <br /> SUPERVISOR/ LEAD SENIOR Approval: Date: <br /> OA 11 Check Off List: Proofread Report? Correct LAND USE k? <br /> Correct CONDITION(S)7 Logged in LAND USE Book? <br /> EH 06 06 Report#7201 Pa;:e November 17,2004 <br />