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NOTE: PULL ALIS,_-,ERMITS (Septic, Well, etc.) MAKE .,;PIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0008735 <br /> DATE RECEIVED by EHD: May 02,2011 APPL#: PA-1100066 <br /> Referral Agency STAFF CONTACT: KEVIN SWANSON PE : 2622 <br /> ., <br /> SUBDIVISON-MINOR(MS) <br /> COMPLETE & SUBMIT BY: Tue, May 17, 2011 . <br /> Assigned to : EE0004045 TASIOPOULOS <br /> SITE ADDRESS: 29665 S KASSON RD, TRACY APN : 25527006 <br /> In completing the Land Use investigation, draw all Public Health factors on the exhibitli.e., sewage disposal, water <br /> supplies, etc...). Wherenecessary, on an attached piece of plain paper, draw complete reap of area showing population <br /> density, location of house, wind direction, etc.... <br /> Public Water' Public Sewer: J/ <br /> ' Name of Purveyor .f Name of System <br /> SUMMARY OR COMMENTS: �E— y <br /> V <br /> II' � <br /> "d <br /> I recommend;.. Approval Denial Continuance Inspe <br /> �- � • <br /> Supervisor/Lead Senior COMMENTS: ' Sign-azure <br /> O <br /> o� 0 r "?Ao' <br /> 5 <br /> 206 , 01 7,0 / 1 ; <br /> gTE Zv 0 <br /> rc- <br /> II <br /> 2Ze � H 'r <br /> 1 - A2 7'1,.t <br /> A. <br /> SUPERVISOR/LEAD SENIOR Approval �! <br /> ., <br /> Date <br /> OA 11 Check Off List a= w PrQafYead Itep rt7 � E 1 9 <br /> a.�y nd`�°s}s;.,;&:: r ay» k' a;:- - rs:"'� "tins` �3g.. _.# <br /> LOD 2 ',1�TS ._ 'rs 'd�; ,.,.•7 `? �,.. i -z• '`�: <br /> 5 <br /> IT t} . �n L4Ni3 U E lioo7C _`. <br /> EH 06 06 Report 97201 <br /> May 03,2011 <br />