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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0009045 <br /> DATE RECEIVED by EHD: January 27,2012 APPL#: PA-1200011 <br /> Referral Agency STAFF CONTACT: RICK GRIFFIN PE : 2626 <br /> IIBE PERMIT-GENE (UP) � <br /> COMPLETE & SUBMIT BY: Wed, February 8, 2072 <br /> Assigned to : EE0004045 TASIOPOULOS <br /> SITE ADDRESS: 920 W FREWERT RD, LATHROP APN : 19126022 <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, win tion, etc.... <br /> Public Water: Public Sewer: <br /> Name of P eyor 1 Name of System <br /> SUMMARY OR COMMENTS: �j �_ ✓tSi j , o-- Watt � <br /> / it VD <br /> 1 d <br /> C.` 1541A/ L <br /> C eA_ <br /> /0g-oz" 2e Aw <br /> I recommend: Approval ® Denial Continuance Inspector: <br /> � <br /> Su ervisor/Le d Senior COMMENTS: Blgnature <br /> �o <br /> 07 ✓ro +b t.0 f, onCG OT Sd(10.� WaS-�G c:.l r`ft 2S/i_c w� rt <br /> 7i .-vet o ve I Qg.m-[.., rr 0:-74y 1 t f-u a n cc <br /> v� Yde C-t d i.J& Tce c (1-f7'es Au-411+'40 + <br /> SUPERVISOR/ LEAD SENIOR Approval: Date: i <br /> OA 11 Check Off List' Proofread Report?_ Correct LAND USE# <br /> Correct.CONDITION(S)? Logged in LAND USE Book . <br /> EH 06 06 Report#7201 January 30,2012 <br />