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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0010261 <br /> DATE RECEIVED by EHD: October 10,2014 APPL#: PA-1400190 <br /> Referral Agency STAFF CONTACT: JOHN FUNDERBURG PE : 2686 <br /> GP TEXT AMENDMENT-GENERAL <br /> COMPLETE&SUBMIT BY: Tue, November 4, 2014 (TG) <br /> Assigned to : EE0004045 TASIOPOULOS <br /> SITE ADDRESS: MOUNTAIN HOUSE PKWY, MOUNTAIN HOUSE APN : <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: <br /> I recommend: Approval Denial 1:1 Continuance Inspector: - <br /> re <br /> Supervisor/Lead Senior COMMENTS: <br /> 17 <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> OA 11 Check Off Ust- Proofread Report? Correct LAND USE#'? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 October 15,2014 <br />