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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: S00010563 <br /> DATE RECEIVED by EHD: July 22,2015 APPL#: PA-1500054 <br /> Referral Agency STAFF CONTACT: STEPHANIE STOWERS PE : 2626 <br /> USE PERMIT-GENERAL(UP) <br /> COMPLETE& SUBMIT BY: Wed, August 5, 2015 <br /> Assigned to: EF0004045 TASIOPOULOS <br /> SITE ADDRESS: 30109 GROOMS RD, OAKDALE APN : 20729061 <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: -rl/—Z <br /> I recommend: Approval Denial Continuance Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> V <br /> (A � S3 : oz <br /> SUPERVISOR/LEAD SENIOR Approval: Date: Ll <br /> [-QA��k Off List: Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 lulc 22.201 <br />