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NOTE: PULL ALL–rERMITS (Septic, Well, etc.) MAKEZ.oPiES FOR FILE —� <br /> LAND USE REPORT RECORD ID: 500007583 <br /> DATE RECEIVED by EHD: February 06,2009 APPL#: PA-0900015 <br /> Referral Agency STAFF CONTACT: JASON JONES PE : 2631 <br /> SITE APPROVAL-MINOR(SA) <br /> COMPLETE & SUBMIT BY: Tue, March 3, 2009 <br /> Assigned to : EE0004045 TASIOPOULOS <br /> SITE ADDRESS: 19755 E HWY 120 , ESCALON APN : 20508020 <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: – ��f Public Sewer: <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: z � ' 3 <br /> t <br /> IV <br /> �- <br /> commend: Approval Denial Continuance Inspectgr <br /> afore <br /> ervisor/Lead Senior COMMENTS:. -�` - <br /> I'I2YISOR 1-I W �,FNIOR kppnral: - I1n tr: '7 7 <br /> lI Check Off List: Pruotread Report' Correct I.AND USF #'? <br /> Correct CONDI I10N(Sl? I ogged in LAND I.1SF. Rook? <br />