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NOTE: PULL ALL w-ERMITS (Septic, Well, etc.) MAKE--..JPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0005328 <br /> DATE RECEIVED by EHD: August 23,2005 APPL#: PA-0500537 <br /> Referral Agency STAFF CONTACT: CEALY LEIN PE: 2640 <br /> { 5 P M LOT LINE ADJUSTMENT(LA) <br /> COMPLETE & SUBMIT BY: "' Assigned toEE0000149 BORGES <br /> SITE ADDRESS: 13343 S VAN ALLEN RD,ESCALON APN : 20513014-16,& <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 /> [ recommend: Approval Denial El Continuance ❑ Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> SUPERVISOR 1 LEAD SENIOR Approval: , <br /> Date: <br /> Proofread Report? is Correct LAND IISE ? y„ �; r :�"' ' <br /> OA Il Check Off Lrsf ., z -- _ ,.f,z r o t x s�i r. ,'Har x r �� � <br /> t h; <br /> 4d ;Correct CONDITIONS)�, ;.:.Y.ole .gged an LAND USE Book? � , #hry: =w.: ��... <br /> Eli 06 06 Report#7201 August 24,2005 <br />