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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0012053 <br /> DATE RECEIVED by EHD: June 17,2019 APPL#: PA-1800289 <br /> Referral Agency STAFF CONTACE STEPHANIE STOWERS PE : 2631 <br /> SITE APPROVAL-MINOR(SA) <br /> COMPLETE&SUBMIT BY: Thu, July 11, 2019 <br /> Assigned to : EE0009825 AFONSKAIA <br /> SITE ADDRESS: 37 E HOSPITAL RD, FRENCH CAMP APN : 19316004 <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: C 4,„A� ,� ,71-&may ' t 1 7" <br /> ,. Z��ILZyf l f <br /> She v�� -� 7-�, -«, Ste d�..'1u1. ac�'✓� ik^ fc,r oHs�}r ���� t tvv^� C)hWr'v44by,0 <br /> I recommend: Approval ❑ Denial ❑ Continuance ❑ Inspector: <br /> Signature <br /> Sunervisor/Lead Senior COMMENTS: <br /> c ; <br /> v� <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> OA 11 heck Off List: Proofread Report? Correct LAND USE#'? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 June 28,2019 <br />