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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0012008 <br /> DATE RECEIVED by EHD: December 19,2018 APPL#: PA-1800039 <br /> Referral Agency STAFF CONTACT' JOHN FUNDERBURG PE : 2608 <br /> MASTER PLAN(MP) <br /> COMPLETE& SUBMIT BY: Thu, January 3, 2019 <br /> Assigned to : EE0000034 AHMED <br /> SITE ADDRESS: 17590 S KELSO RD, MOUNTAIN HOUSE APN : 25803001 <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: rt4�/�sy Public Sewer: M P00'a--sp <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: <br /> eo. ^OvA+ O�o <br /> I recommend: Approval ❑ Denial El Continuance ❑ Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> L1 TZ(%LVC/b!T[[vc/ ( CMZ (2��i�/_�,�IIXI�= <br /> SUPERVISOR/LEAD SENIOR Approval: Date: +� <br /> A II h k ff Li : Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 December 2l,2018 <br />