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DOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: S00010212 <br /> DATE RECEIVED by EHD: August 29,2014 APPL#: PA-1400168 <br /> Referral Agency STAFF CONTACT: RICI G IF N PE : 2690 <br /> to LOT LINE ADJUSTMENT(LA) <br /> COMPLETE&SUBMIT BY: AZjAF-bY. <br /> Assigned to : EE0005944 ESCOTTO <br /> SITE ADDRESS: 15843 N TULLY RD, LODI APN : 05304007 08 <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: -k� -1 <br /> G ',A'w 4 .S� xL QF C .'4 -F KW <br /> -4 <br /> 6WE604 I /k� U&ai. 2x ju jaa� <br /> �T <br /> I recommend: Approval EZ Denial Continuance Inspecto . <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> D�6' X, C e Kr,4 t er��;�i, �'i ,�,. 3 c 71L,° <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report 117201 August 29,2014 <br />