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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0005251 <br /> DATE RECEIVED by EHD: October 10,2006 APPL#: PA-0500464 REVISI <br /> Referral Agency STAFF CONTACT: KARLA KUHL PE : 2631 <br /> SITE APPROVAL-MINOR(SA) <br /> COMPLETE& SUBMIT BY: Wed, October 18, 2006 <br /> Assigned to : EE0005366 MEDINA <br /> SITE ADDRESS: 12786 E TOKAY COLONY RD, LODI APN : 06328026 <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: r, Public Sewer: <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: �- <br /> �a��� <br /> oy <br /> I recommend: Approval E—Denial F-1 Continuance Insp ctor• <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> o�4 <br /> GI z 2 <br /> SUPERVISOR/LEAD SENIOR Approval: ` Date: ✓ <br /> .,. .� <br /> h �fCst oo aci' <br /> * x <br /> ter, r <br /> EH 06 06 Report#7201 October 11,2006 <br />