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NOTE: PULL ALL) ERMITS (Septic, Well, etc) MAKE`as$PIES FOR FILE <br /> LAND USE REPORT RECORD ID: UU0004857 <br /> DATE RECEIVED by EHD: February 22,2005 ADPL#: PA-04-737 <br /> Referral Agency STAFF CONTACT: BILL FACTOR PE : 2611 <br /> COMPLETE&SUBMIT BY: Tue, March 8, 2005 SUBDIVISION-MAJOR(SU) <br /> Assigned to : EE0000149 BORGES <br /> SITE ADDRESS: NEIGHBORHOOD E , MOUNTAIN HOUSE APN : NUMEROUS <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 /> I recommend: Approval Denial F] Continuance Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> Q <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> OA /l Check Off List: Proofread Report? �i Correct LAND USE#? <br /> Correct CONDMON(S)? Logged in LAND USE Book? <br /> EH 06 06 Report 47201 Page 3 February 24,2005 <br />