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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0009460 <br /> DATE RECEIVED by EIID: December 21,2012 APPL#: PA-1200254 <br /> Referral Agency STAFF CONTACT: CORINNE E KING PE : 2690 <br /> LOT LINE ADJUSTMENT(LA) <br /> COMPLETE&SUBMIT BY: <br /> Assigned to : EE0004045 TASIOPOULOS <br /> SITE ADDRESS: MOUNTAIN HOUSE PK T—*OUNTAIN HOUSE APN : 25637005 07 08 091013 1415 <br /> M ilp is f9 29 24 e5-- <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 /> N e of Purveyor /Name of System <br /> SUMMARY OR COMMENTS: Z 4o yew <br /> a4/ <br /> I recommend: Approval F Denial Continuance Inspector <br /> Supervisor/Lead Senior COMMENTS Signature <br /> 464 <br /> SUPERVISOR/ LEAD SENIOR Approval: 1 - Date: <br /> OA H Check Off List Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Boob <br /> FH 06 06 Report#7201 December 26,2012 <br />