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f <br /> r <br /> x -f <br /> NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> -LAND USE REPORT RECORD ID: SU0008253 <br /> DATE RECEIVED by EHD: May I4,2010 APDL#: PA-1000104 <br /> Referral Agency STAFF CONTACT: RICK GRIFFIN PE : 2663 <br /> COMPLETE& SUBMIT BY: Wed, May 26, 2010 VARIAI�iCE(VR) <br /> Assigned to : EE0004045 TASIOPOULOS <br /> SITE ADDRESS: 4088 S ESCALON-BELLOTA RD, FARMINGTON APN : <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: <br /> Public Sewer: <br /> Name of Purveyor y Name of System <br /> SUMMARY OR COMMENTS: <br /> [ recommend: Approval Denial E] Continuance Inspec n���� <br /> Supervisor/Lead Senior COMMENTS: - <br /> SUPERVISOR I LEAD SENIOR Approval: Date: 1 <br /> DA f!Check Off L rsf 1'r4ofread Ctepot2` W ' P correct LiND USS!# x � � <br /> ' .Eg a�`.a, (7N <br /> .r. .e3 'x n. "M' 'al <br /> a. : .r, Crract CONOITT5 2 r ' s,. .sem LoggcE t IAN TJ$Fvl3oplC� .. 09 <br /> ,, ggg .�fls ' <br /> EH 06 06 Report 117201 <br /> May 17,2010 <br />