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r . <br /> NOTE: PULL ALL . RMITS (Septic, Well, etc.) MAKE MIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0006655 <br /> DATE RECEIVED by EHD: July 31,2007 APPL#: PA-0700342 <br /> Referral Agency STAFF CONTACT: JASON JONES PE : 2622 <br /> SUBDIVISON-MINOR(MS) <br /> COMPLETE& SUBMIT BY: Tue, August 21, 2007 <br /> Assigned to : EE0005366 MEDINA <br /> SITE ADDRESS: 96 E WOODBRIDGE RD, WOODBRIDGE APN : 01522017 <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: �r�P� Public Sewer: �.�j�n, ��� <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: <br /> 206:02 <br /> Note: The Environmental Health Department received a Surface Subsurface <br /> Contamination Report (Service Request#SR 0051315) dated July, 2007 that <br /> has not been approved. Prior to recordation of Parcel Map, the report must be <br /> reviewed and found acceptable by the Environmental Health Department. <br /> 10:05 <br /> Strike"Public Works Department"and insert"Woodbridge Sanitation District" <br /> 20:04 <br /> Strike"water providers"and insert"Mokelumne Acres Water District" M <br /> 22:03 N <br /> ADD: an or an ell"permit shall be taken o icant <br /> at the Environmental Health Department. ermit and inspection by the N <br /> Environmental Healt staff is $100.00. The perms finaled prior <br /> to r on of Parcel Map. <br /> ho <br /> P;?o Clip- 7 , <br /> f 0 C, <br /> U m a t d u4 g & /ll �3 <br /> SUPERVISOR/LEAD SENIOR Approval: - Date: l:> <br /> A'I/sC�►eck Off L:sL , PlQofre �z ? <br /> x1r ; rG �1a ORIV AWNR �I?taar N�ro �f'R <._. »LCr 1 <br /> CH 06 06 Report#7201 July 31,2007 <br />