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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0009937 <br /> DATE RECEIVED by EHD: February 14,2014 APPL#: PA-1300219 <br /> Referral Agency STAFF CONTACT: JOHN L FUNDERBURG PE: 2690 <br /> . 01-1 LOT LINE ADJUSTMENT(LA) <br /> COMPLETE &SUBMIT BY: a -A4 , t„ ^,�+ <br /> Ra �-- Assigned to : EE0004045 TASIOPOULOS <br /> R <br /> SITE ADDRESS: 16504 S HENRY D, OAKDALE APN: 22918001 22921001 <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 Pu eyor Name of System <br /> SUMMARY OR COMMENTS: <br /> � w <br /> / C <br /> I recommend: Approval Ea Denial El Continuance Inspector• <br /> ignature <br /> Supervisor/Lead Senior COMMENTS: <br /> - <br /> SUPERVISOR/LEAD SENIOR Approval: - Date: <br /> OA I/Check Off List; <br /> Ppgfreadte��r� Correct'LAND USE#7 <br /> � <br /> Correct bI�DIT IONp_." Lo*d in LAND USEBook 3' <br /> EH 06 06 Report 47201 February 18,2014 <br />