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NOTE: PULL ALe _-ERMITS (Septic, Well, etc.) MAKE %-JP1ES FOR FILE <br /> LAND USE REPORT RECORD ID: S0006 10 <br /> DATE RECEIVED by EHD: January 28,2011 APPL#: PA-1100013 <br /> Referral Agency STAFF CONTACT: RICK GRIFFIN PE: 2626 <br /> COMPLETE&SUBMIT BY: Wed, February 9, 2011 USE PERMIT-GENERAL(UP) <br /> SITE ADDRESS: 21000 E ACAMPO RD, CLEMENTS Assigned to : EE0005944 ESCOTTO <br /> APN : 02308015 <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 /> SUMMARY OR COMMENTS-Name of Purveyor Name of System <br /> / <br /> '12- <br /> 1 recommen pprova Denial Continuance Inspecto <br /> Supervisor/Lead Senior COMMENTS: Signature <br /> v <br /> 10 <br /> i <br /> # -ZZ 0 <br /> SUPERVISOR/LEAD SENIOR Approva] i f <br /> r <br /> D <br /> ate <br /> F x.':.»�i; n -. -. ,._ a- Fiat^-s••. =•t.,.»-.�.y-sr='-�;��3'`P.s`$�, 6 i h., „.�,r• ':� : 1 ;z�`? " <br /> EH 06 06 Report 117201 <br /> January31,2011 <br />