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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0011372 <br /> DATE RECEIVED by EHD: May 30,2017 APPL#: PA-1700114 <br /> Referral Agency STAFF CONTACT' STEPHANIE STOWERS PE : 2632 <br /> SITE APPROVAL-GENERAL(SA) <br /> COMPLETE& SUBMIT BY: Wed, June 14, 2017 Assigned to : EE0004045 TASIOPOULOS <br /> SITE ADDRESS: 31199 S KOSTER RD,TRACY APN : 25531040 <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 Sew <br /> Name of P eyor Name of System <br /> SUMMARY OR COMMENTS: � � 2�G /9,7—c- ia> _, YEA 4 <br /> S1N✓t en ✓Nall . <br /> s <br /> ZZ P17(J — sewu�c cm. rw�oAi /1✓h w..,'�cv .�cc �..r.<. Iv� //very F <br /> AgeX i'4iGeeuw�u -��i✓eon I 6 <br /> A,2'.0 I — 'Ut I�Go✓tadn��hT^ <br /> c <br /> I recommend: Approval Denial Continuance Inspector: <br /> ,j Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> = ll;o <br /> To IX�r-cv_uw iF THS Deerflrsuu j•,��to CAA i as - <br /> 7C�II�if�2,i/1 A7 - DKhx TO 7Sti1A�(/-E <br /> 4)) I t I/U7 QZ UGI UN/L1,7 <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> OA II Check OK List: Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report 47201 May 31,2017 <br />