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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0009462 <br /> DATE RECEIVED by EHD: December 21,2012 APPL#: PA-1200247 <br /> Referral Agency STAFF CONTACT: CORINNE E KING PE : 2622 <br /> SUBDIV ISON-MINOR(MS) <br /> COMPLETE&SUBMIT BY: Tue, January 22, 2073 <br /> Assigned to: EE0004045 TASIOPOULOS <br /> SITE ADDRESS: 5613 W DURHAM FERRY RD, TRACY APN : 25331049 50 <br /> [n 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 /> �/ <br /> Public Water: Public Sewer: --t <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS- <br /> Al2 <br /> n s� C�a.�er riQIL" 7crn <br /> 1 <br /> 12 0/ G�l oars �ncs`t r� Sa r� Sw �S�R tri �o <br /> 'S wv <br /> [ recommend: Approval Denial El Continuance El Inspecto <br /> si�nam rc <br /> Supervisor/Lead Senior COMMENTS: <br /> h • <br /> k �1h2 T� l�A�c� DAY-�Vkl'V . /fin ,�M.vT_A/Du,�s TD <br /> r�rFMA. 5�lt3tifY(�I7 'fes N� E�tl/Vl�yl✓Nl'C9�/l <br /> J� 17�bic(Z(L1 r✓l it �PUV�V `4S�:ZWj!5 G(Ni a bU <br /> y00 oZ <br /> 1, <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> OA/I Check Off List: Proofread Report? Correct LAND.USE# <br /> Correct CONDHION(S)? Logged in LAND USE Book? <br /> 1111 06 06 Report 07201 December 26,2012 <br />