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�y <br /> NOTE: PULL ALI�rERMITS (Septic, Well, etc.) MAKE'udPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0005754 <br /> DATE RECEIVED by EHD: November 04,2005 APPL 9: PA-0500740 <br /> Referral Agency STAFF CONTACT: ANTONIO SALCEDO PE : 2690 <br /> LOT LINE ADJUSTMENT(LA) <br /> COMPLETE&SUBMIT BY:^ A,S.A . <br /> Assigned to : EE0004045 TASIOPOULOS <br /> SITE ADDRESS: 5851 W UNDINE RD, STOCKTON APN: 19105011 <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 /> 5G <br /> ab c <br /> I recommend: Approval Denial Continuance Inspecto �9�—�:- �ignature <br /> Supervisor/Lead Senior COMMENTS: <br /> i <br /> SUPERVISOR/LEAD SENIOR Approval: Date: C 6 <br /> 4 A .,_ .,. <br /> EH 06 06 Report 47201 November 04,2005 <br />