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NOTE: PULL ALL-. ERMITS (Septic, Well, etc.) MAKE-zOPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0007337 <br /> DATE RECEIVED by EHD: August 18,2008 APPL#: PA-0800244 <br /> Referral Agency STAFF CONTACT: CORINNE KING PE : 2622 <br /> SUBDIVISON-MINOR(MS) <br /> COMPLETE& SUBMIT BY: Tue, September 2, 2008 <br /> Assigned to : EE0005366 MEDINA <br /> SITE ADDRESS: 9855 W HWY 12 , LODI APN : 02508001 <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 /> y <br /> I recommend: Approval ©Denial Continuance I Spect <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> C ,z e .y c 11� ro <br /> e 1 z.a n <br /> ERV'IS012 LEADSENIOR .l pprocal: �- - Da(v: <br /> 6� b <br /> 'tl Check Off List: proofread Report'? Correct LAND tiSG#') <br /> 1 Correct CONDIIION(S)'? Loggrd in LAND I,SP: Rook° itr <br /> EH 06 06 Report 47201 August 18,2008 <br />