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NOTE: PULL ALL"PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0004105 <br /> DATE RECEIVED by EHD: May 10,2004 APPL#: PA-04-236 <br /> Referral Agency STAFF CONTACT: RAYMOND HOO PE : 2631 <br /> SITE APPROVAL-MINOR(SA) <br /> COMPLETE&SUBMIT BY: Tue, June 1, 2004 Assigned to : EE0000811 HUGGINS <br /> SITE ADDRESS: 9948 S HARLAN RD,FRENCH CAMP APN: 19327017 <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: <br /> I recommend: Approval ❑ Denial F-1 Continuance ❑ Inspector: <br /> Signature <br /> Suoervisor/Lead Senior COMMENTS: <br /> ..tin�`hC� �S' QfM1 <br /> y% <br /> SUPERVISOR/LEAD SENIOR Approval: Date: � CJ"u <br /> OA l/Check Off List: Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 Page 9 May 12,2004 <br />