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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0010375 <br /> DATE RECEIVED by EHD: January 30,2015 APPL#: PA-1500012 <br /> Referral Agency STAFF CONTACT: RICK GRIFFIN PE : 2690 <br /> S <br /> a"`"�+! �* LOT LINE ADJUSTMENT(LA) <br /> COMPLETE& SUBMIT BY: A HI " <br /> Assigned to : EE0004045 TASIOPOULOS <br /> SITE ADDRESS: 11650 E MONCURE RD, RIPON APN : 25729025 26 <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: Z v�• c � � <br /> w <br /> I recommend: Approval Denial F-1 Continuance ❑ Inspector: <br /> ,S�naTure <br /> Supervisor/Lead Senior COMMENTS: <br /> SUPERVISOR/LEAD SENIOR Approval: 1 Date: 2 lZ <br /> / Off Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report 47201 February 02,2015 <br />