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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0011430 <br /> DATE RECEIVED by EHD: July 17,2017 APPL#: PA-0500143 <br /> Referral Agency STAFF CONTACT JOHN FUNDERBURG PE : 2611 <br /> SUBDIVISION-MAJOR(SU) <br /> COMPLETE&SUBMIT BY: Fri, August 4, 2077 Qn\- , W'{M I0n <br /> Assigned to : EE0004045 TASIOPOULOS <br /> SITE ADDRESS: 23323 S MOUNTAIN HOUSE PKWY,MOUNTAIN APN : 20906040 <br /> HOUSE <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: �1 , Public Sewer: <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: <br /> U� <br /> I recommend: Approval Denial ContinuanceEl <br /> Inspect0 <br /> r atore <br /> Supervisor/Lead Senior COMMENTS: <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> OA 11 Check Off List: Proofread Report? Correct LAND USE#? <br /> Correct CONDrrION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report 47201 July 19,2017 <br />