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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0008967 <br /> DATE RECEIVED by EHD: November 14,2011 APPL#: PA-1100210 <br /> Referral Agency STAFF CONTACT: RICK GRIFFIN PE : 2690 <br /> a 04LOT LINE ADJUSTMENT(LA) <br /> COMPLETE&SUBMIT BY: AMP—BY <br /> Assigned to : EE0005944 ESCOTTO <br /> SITE ADDRESS: 5100 E ACAMPO RD,ACAMPO APN : 01731020 22 <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 /> /!92E�Z t't/ l�� �1���t c, �1S�s75�1rzv C� t//.✓,may rLir �S �r/cu-42Lk <br /> e'/° Iy�s i f7J <br /> 'cz 4*y/�Z <br /> I recommend: Approval Denial Continuance Inspecto , <br /> Supervisor/Lead Senior COMMENTS: Signature <br /> SUPERVISOR/ LEAD SENIOR Approval: Date: e� Z <br /> OA 11 Check OH List: Proofread Report? - Correct LAND USE#? <br /> Correct CONDITION(S)? - Logged in LAND USE Book? - <br /> EN 06 06 Report#7201 <br /> November 13,2011 <br />