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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0005344 <br /> DATE RECEIVED by EHD: August 26,2005 APPL#: PA-0500531 <br /> Referral Agency STAFF CONTACT: KATHY ALLEN PE : 2627 <br /> USE PERMIT-MAJOR(UP) <br /> COMPLETE&SUBMIT BY: Wed, September 14, 2005 <br /> Assigned to : EE0005366 MEDINA <br /> SITE ADDRESS: 4620 E WOODBRIDGE RD, ACAMPO APN : 01709002 <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: --71ep Public Sewer: 1--77C <br /> Name.of Purveyor Name of System <br /> SUMMARY OR COMMENTS: '—t<�c.G/ <br /> I recommend: Approval Denial Continuance Inspec r: � <br /> gnature <br /> Supervisor/Lead Senior COMMENTS: <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> OA 11 Check Off List: Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 August 26,2005 <br />