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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0011093 <br /> DATE RECEIVED by EHD: October 13,2016 APPL H: PA-1600240 <br /> Referral Agency STAFF CONTACT: ALISA GOULART PE : 2631 <br /> SITE APPROVAL-MINOR(SA) <br /> COMPLETE& SUBMIT BY: Wed, October 26, 2016 <br /> Assigned to : EE0004045 TASIOPOULOS <br /> SITE ADDRESS: 20500 S HOLLY RD, TRACY APN : 21216010 <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 A <br /> SUMMARY OR COMMENTS: 4e)1-Z_� �6 <br /> 7 <br /> ,/,O;L 5771/YH�'T/NiDti'N� y � QLSa� i�1 M <br /> I recommend: Approval Denial Continuance Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> fA-) <br /> Ag) 11:.07 I Rhe- Tn IssuA /Ls a-E EUa,m4 P* { - <br /> $d 11,03 (A) <br /> C) Zzd I <br /> z2=off <br /> oNN S Y ?" <br /> EA <br /> 49 <br /> 1 � <br /> SUPERVISOR/ LEAD SENIOR Approval: Date: <br /> OA 11 Check Off Li Proofread Report? Correct LAND USI,k'? <br /> Correct CONDITION(S)? Logged in LAND USE Hook? <br /> EH 06 06 Report 47201 October 14,2016 <br />