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NOTE: PULL ALL-,,dRMITS (Septic, Well, etc.) MAK"PIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0003421 <br /> DATE RECEIVED by E13D: April 13,2004 APPL#: PA-04-171 <br /> Referral Agency STAFF CONTACT: JOHN FUNDERBURG PE : 2631 <br /> SITE APPROVAL-MINOR(SA) <br /> COMPLETE&SUBMIT BY: Tue, May 4, 2004 Assigned to: EE0000149 BORGES <br /> SITE ADDRESS: 301 E FRENCH CAMP RD,FRENCH CAMP APN: 19313031 <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: y <br /> �& �r' <br /> I recommend: Approval El Denial F Continuance F-1 Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> 6 <br /> s O� -tel <br /> aoa/_ %7. <br /> �iYyY F-F/- 6 YA'0/ d / im X-ei <br /> �o I tld <br /> SUPERVISOR/LEAD SENIOR Approval: - ti r,, Date: <br /> OA II Check OH List., Proofread Report? (i' Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> Ell 06 06 Report#7201 Pagel April 16,2004 <br />