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NOTE: PULL ALL hrRMITS (Septic, Well, etc.) MAKE 6.491E8 FOR FILE <br /> LAND USE REPORT RECORD ID: S00003434 <br /> DATE RECEIVED by EHD: April 22,2004 APPL#: PA-04-206 <br /> Referral Agency STAFF CONTACT: RICK GRIFFIN PE : 2625 <br /> USE PERMIT-MINOR(UP) <br /> COMPLETE& SUBMIT BY: Wed, May 12, 2004 Assigned to : EE0000018 TRINDADE <br /> SITE ADDRESS: 15301 E FRENCH CAMP RD, FRENCH CAMP APN : 20311009 <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 ❑ Continuance El Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS, <br /> Q � <br /> c /- <br /> Q � ) —I <br /> n � Off^ <br /> 11 .P '3 <br /> a NO s' -c' i 4N/BI1C �v /fi//1/ <br /> ,r ll D / 54W p-V s/fz /,V" 5-60 44 <br /> -i7 X2 /L°6411 <br /> Obi , s /- S/ ,� ® P�i1�✓ S Z <br /> `1 9 l5 <br /> c,04 <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> OA 11 Check Off List Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> 6 Report 97201 Page 3 Apn129,2004 <br />