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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0010156 <br /> DATE RECEIVED by EHD: July 25,2014 APPL#: PA-1400148 <br /> Referral Agency STAFF CONTACT: JOHN FUNDERBURG PE: 2690 <br /> LOT LINE ADJUSTMENT(LA) <br /> COMPLETE &SUBMIT BY: <br /> I SARBY, Assigned to : EE0004045 TASIOPOULOS <br /> SITE ADDRESS: 111 HUNTINGTON AVE, MOUNTAIN HOUSE APN: 26205022 23 <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: Vr 5 Public Sewer: <br /> ame of Purveyor Name of System <br /> SUMMARY OR COMMENTS: <br /> I recommend: Approval ® Denial Continuance Inspec- �'j'�� <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> SUPERVISOR/LEAD SENIOR Approval: Date: 0. t <br /> m, <br /> e Ear 5��zixa€0,04 <br /> ._, _�",,.s;�'; x ., �-.aha.,,_,a ...u„^.... .• �'+� ,, a,- tea....:. <br /> a . <br /> EH 06 06 Report#7201 July 25,2014 <br />