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,��. •Y"�'�wr � Jam; <br /> e 1 <br /> NOTE: PULL ALVPERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0004731 <br /> DATE RECEIVED by EHD: November 30,2004 APPL#: PA-04-304(PC) <br /> Referral Agency STAFF CONTACT: JOHN FUNDERBURG PE : 2650 <br /> APPEAL TO BOS(805)or PC(PC) <br /> COMPLETE &SUBMIT BY: Tue, December 21, 2004 <br /> Assigned to : EE0000149 BORGES <br /> SITE ADDRESS: 360 W BOWMAN RD,FRENCH CAMP APN : 19326022 <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 game of System <br /> SUMMARY OR COMMENTS: <br /> t. <br /> I recommend: Approval Denial Continuance Inspector: <br /> Signature <br /> Suoervisor/Lead Senior COMMENTS: <br /> SUPERVISOR 1 LEAD SENIOR Approva . Date: <br /> =0A11 Check Off List: Proofread Re o 9 Correct LAND USE ? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> December 13,2064 <br /> EH 06 06 Report ft7201 � �/ Page 2 <br />