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3 <br /> NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0011992 <br /> DATE RECEIVED by EHD: October 08,2018 APPL#: PA-1800259 <br /> Referral Agency STAFF CONTACT CHRISTINE LUCKASEN PE : 2631 <br /> SITE APPROVAL-MINOR(SA) <br /> COMPLETE&SUBMIT BY: Thu, November 1, 2018 <br /> Assigned to : EE0000034 AHMED <br /> SITE ADDRESS: 25 E FRENCH CAMP RD, FRENCH CAMP APN : 19307002, 19302001 <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: ACN k Public Sewer: Ryy,r, <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: <br /> Iclef 19 c, .Q, e 4irt111 1 oof U4- SPr✓ ee Psrrn Y rSSv*.4 sh���Z• <br /> 2 oyell a(*,0roc 0-A lo•rn, -'4S <br /> 2 Spp4,,l -/.0014 p0rm, '71 oLo h^11e <br /> sl}Oy,5i'r, absf✓—jy.14 o.F' So.-✓.c ....e,L.� <br /> Z 2:dl 21:03 360;b.f 'Tru�4 r 't luck:n• "A <br /> 114 <br /> y> .01 2ro7 <br /> I recommend: Approval21 Denial ❑ Continuance El Inspector: rye�. r rfii. <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: / <br /> DSD IO(Z��zal o�,Szl. <br /> 66r� C� <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> A II h k ff Li : Proofread Report? V Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report 97201 October 09,2018 <br />