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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0012061 <br /> DATE RECEIVED by EHD: November 19,2018 APPL#: PA-1800291 <br /> Referral Agency STAFF CONTACT CHRISTINE LUCKASEN PE : 2631 <br /> SITE APPROVAL-MINOR(SA) <br /> COMPLETE&SUBMIT BY: Thu, December 20, 2018 <br /> Assigned to : EE0000034 AHMED <br /> SITE ADDRESS: 8355 S MANTHEY RD, FRENCH CAMP APN : 19317037 <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: �onL Public Sewer: <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: <br /> / Pyr[. J064 Porn-,?- o- A'le. <br /> e VoeMA+'7 644 '",960t- 4L fru e, Z 7-,'A,'le,- PAI-144 <br /> i1ty1 <br /> I recommend: Approval ❑ Denial ❑ Continuance ❑ Inspector:ffA-&<w*-A'1 '7 <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> OA 11 Check Off List," Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? : <br /> EH 06 06 Report#7201 November 20,2018 <br />