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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0011225 <br /> DATE RECEIVED by EHD: February 09,2017 APPL#: PA-1700018 <br /> Referral Agency STAFF CONTACT: RICK GRIFFIN PE : 2690 <br /> LOT LINE ADJUSTMENT(LA) <br /> COl�/�� �' Assigned to : EE0004045 TASIOPOULOS <br /> SITE ADDRESS: 36 W MATHEWS RD,FRENCH CAMP APN : 19317002 <br /> In completing the Land Use investigation, draw all Public Health factors on the exhibit (i.e., sewage disposal, water <br /> supplies, etc...). Where necess on an attached piece of plain paper, draw complete map of area showing population <br /> density, location of hous nd direction, etc.... L� <br /> Public Water: Public Sewer: <br /> Name of Purveyor Name of System <br /> SUMMAR OR COMMENTS: <br /> I recommend: Approval Denial ❑ Continuance ❑ Insp <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> 06 ) A/b ogrr�czra,J 71zr/(7 <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> A it Ch,,k Off List: Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report 47201 February 10,2017 <br /> J <br />