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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0012009 <br /> DATE RECEIVED by EHD: December 19,2018 APPL#: PA-1800040 <br /> Referral Agency STAFF CONTACT JOHN FUNDERBURG PE : 2638 <br /> SPECIFIC PLAN(SP) <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: INf/e-sy Public Sewer: *11rsp <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: <br /> I recommend: Approval Denial ❑ Continuance El Inspector: tA-4- 4 <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> Il h k Li • Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Repon 47201 December 21,2018 <br />