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NOTE: PULL ALL,.—RMITS (Septic, Well, etc.) MAKE kw-PIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0006412 <br /> DATE RECEIVED by EHD: January 30,2007 APPL#: PA-0700021 <br /> Referral Agency STAFF CONTACT: MO HATEF PE : 2626 <br /> USE PERMIT-GENERAL(UP) <br /> COMPLETE&SUBMIT BY: Wed, February 7, 2007 <br /> Assigned to : EE0005944 ESCOTTO <br /> SITE ADDRESS: 5184 W HWY 12 , LODI APN : 05516072 <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: <br /> & <br /> ff" � <br /> � 7j��S/d� ac}%�17rt�� Ak/l�Ccs�-+rte lrl7li �/IG✓�3"Z/GG��fi $'"SG�I/G,3'Y'�c��J T/1./�u-o�'y <br /> �-r�/!�J&-n' !�fl-//1�//YL�LEe3CLIG/�✓y✓�fhbl��/1�7 <br /> /.19 Cr= l/ f�o �t/��4/S��)!S l�G✓�1-DliZf-G�7/3�2ct��iiL 7�1c5 5/� <br /> e <br /> I recommend: Approval D Denial Continuance F Inspector .41 <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> s <br /> n'-L V <br /> SUPERVISOR/ LEAD SENIOR Approval: Date: <br /> A 11 Check Off List: Proofread Rcport? •" <br /> Correct CONDITION(S)? Log <br /> EH 06 06 Report#7201 January 30,2007 <br />