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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0009324 <br /> DATE RECEIVED by EHD: August 23,2012 APPL#: PA-1200133 <br /> Referral Agency STAFF CONTACT: CORINNE E KING PE : 2631 <br /> SITE APPROVAL-MINOR(SA) <br /> COMPLETE &SUBMIT BY: Wed, August 29, 2012 <br /> Assigned to <br /> SITE ADDRESS: 11075 W LARCH RD, TRACY APN : 21217002 <br /> fn 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 <br /> /OR,COMMENTS: <br /> 1/:454%f6u'� n c L0,.Crvo <br /> qO _ <br /> I recommend: Approval ® enial Continuance Inspec <br /> Supervisor�/,L�e,(ad Senior COMMENTS: <br /> V I � <br /> ( ijJ ( � : O 1 0��n 'Cy �S S N--Nwt-(. b� Q •Q <br /> 22 . 02 , t II t • t <br /> ; o / r <br /> 1 6tD,2) CLw <br /> SUPERVISOR/LEAD SENIOR Approval: Date:Mow vi� <br /> 1 M1 tl <br /> I uges! t Ami Staok <br /> Ell 06 06 Report#7201 August 24,2012 <br />