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SU0010613
EnvironmentalHealth
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2600 - Land Use Program
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PA-1500149
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SU0010613
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Last modified
12/17/2019 8:58:33 AM
Creation date
9/6/2019 10:17:09 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0010613
PE
2638
FACILITY_NAME
PA-1500149
STREET_NUMBER
19629
Direction
S
STREET_NAME
MOUNTAIN HOUSE
STREET_TYPE
PKWY
City
MOUNTAIN HOUSE
Zip
95391-
APN
20904018
ENTERED_DATE
8/27/2015 12:00:00 AM
SITE_LOCATION
19629 S MOUNTAIN HOUSE PKWY
RECEIVED_DATE
8/25/2015 12:00:00 AM
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\sballwahn
Supplemental fields
FilePath
\MIGRATIONS\M\MOUNTAIN HOUSE PKWY\19629\PA-1500149\SU0010613\APPL.PDF
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EHD - Public
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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: S00010613 <br /> DATE RECEIVED by EHD: August 25,2015 APPL#: PA-1500149 <br /> Referral Agency STAFF CONTACT: JOHN FUNDERBURG PE : 2638 <br /> SPECIFIC PLAN(SP) <br /> COMPLETE& SUBMIT BY: Mon, September 14, 2015 Assigned to : EE0004045 TASIOPOULOS <br /> SITE ADDRESS: 19629 S MOUNTAIN HOUSE PKWY,MOUNTAIN APN : 20904018 <br /> HUUNE <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 MMARY <br /> I recommend: Approval � Denial El Continuance Inspector <br /> ature <br /> Supervisor/Lead Senior COMMENTS: <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 August 27.2015 <br />
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