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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: S00011560 <br /> DATE RECEIVED by EHD: October 26,2017 APPL#: PA-1700164 <br /> Referral Agency STAFF CONTACT: RICK GRIFFIN PE : 2690 <br /> LOT LINE ADJUSTMENT(LA) <br /> COMPLETE& SUBMIT BY: Fri, November 3, 2017 <br /> Assigned to : EE0000034 ARMED <br /> SITE ADDRESS: 36 W MATHEWS RD, FRENCH CAMP APN : 19317002, 04, 05 <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: AIM- Public Sewer: Lioiv, <br /> �I Name of Purveyor / Name of System <br /> SUMMARY OR COMMENTS: _ IA �u�� /S\ d�. (4 it/a6�t <br /> FIA l J � <br /> 0ns't4Q✓6"Y- / /Lf/36/17 / <br /> _ I /�Qisc/ "1 (�/.tifR%�e 5/i�/T� ot�itie 6✓�Y�Mv.A/J�aT ovi'/r� Y� kell rs1�D�(� <br /> • �aeee�/�� !Id SLi� ��usib�ewee e/- a.,✓Yd�' d%��2 • <br /> i,,.e toacttiwse , rest' ttw/ -/ S-Vyft sys-lep <br /> �A/,0 h,--j /40 lfimrylOw �!� /2fann�P��a� it iL�� 4/lPlZ�cfia- <br /> I recommend: Approval Denial Continuance ❑ Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> OA II Check Off List: Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> 1111 06 06 Report#7201 Ocn,ber X7.1017 <br />