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F— NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0010572 <br /> DATE RECEIVED by EHD: July 28,2015 APPL#: PA-1500116 <br /> Referral Agency STAFF CONTACT: RICK GRIFFIN PE : 2690 <br /> LOT LINE ADJUSTMENT(LA) <br /> COMPLETE& SUBMIT BY: - '�ARRY <br /> Assigned to: EE0004045 TASIOPOULOS <br /> SITE ADDRESS: 10500 S HARLAN RD, FRENCH CAMP APN : 19327003 <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 /> ame of Purveyor Name of System <br /> SUMMARY OR COMMENTS: <br /> D /r O <br /> I recommend: Approval 0 Denial ❑ Continuance Inspector: <br /> Signature <br /> Sul2ervisor/Lead Senior COMMENTS: <br /> p o <br /> _ � r <br /> SUPERVISOR/LEAD SENIOR Approval: — Date: S <br /> k Off Ust- Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 July 28,2015 <br />