Laserfiche WebLink
NOTE: PULL ALL r-RMITS (Septic, Well, etc.) MAKE �--PIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0006636 <br /> DATE RECEIVED by EHD: July 17,2007 APPL#: PA-0700331 <br /> Referral Agency STAFF CONTACT: MO HA-rVP PE : 2690 <br /> LOT LINE ADJUSTMENT(LA) <br /> COMPLETE& SUBMIT BY: AbAF-bY: <br /> Assigned to : EE0005366 MEDINA <br /> SITE ADDRESS: 15792 N RAY RD, LODI APN : 02514034 35 <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: . r <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: ?. - <br /> r- ,� f <br /> 11:09 <br /> QR t, �ce _ <br /> Prior to issuance of building permit( for. arcels One (1) through Four(4) , a Soil <br /> Suitability Study may be required to be performed and submitted to the Environmental <br /> Health Department with a review fee of$190.00 due at time of submittal. <br /> I recommend: Approval 7 Denial J ❑ Continuance Inspect: <br /> ignature <br /> Supervisor/Lead Senior COMMENTS: <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> OA !1 Check Off List: Proofread Report Correct LAND USE# <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 05 Report#7201 Tulp l� <br />