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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0012615 <br /> DATE RECEIVED by EHD: October 18,2019 APPL#: PA-1900243 <br /> Referral Agency STAFF CONTACT STEPHANIE STOWERS PE : 2626 <br /> USE PERMIT-GENERAL(UP) <br /> COMPLETE& SUBMIT BY: Thu, November 14, 2019 <br /> Assigned to : EE0000418 KITH <br /> SITE ADDRESS: 10400 E HWY 12 , LODI APN: 05112088 <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 /> tF <br /> yka&ij� wan %&Q o F- <br /> 5LT PL-A,NS L tLµ t,SCJ FS <br /> 1--6ST f-o�-\ <br /> I recommend: Approval ❑ Denial ❑ Continuance F-1 Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> SUPERVISOR/LEAD SENIOR Approval: Date: 7"�- <br /> OA Il heck Off List: Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? A <br /> EH 06 06 Report#7201 October 21,2019 <br />