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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE i%c0ORT RECORD ID: SU0010213 <br /> DATE RECEIVED by EHD: August 29,2014 APPL#: PA-1400170 <br /> Referral Agency STAFF CONTACT: RICK GRIFFIN PE : 2690 <br /> 04 A <br /> LOT LINE ADJUSTMENT(LA) <br /> COMPLETE&SUBMIT BY: Ab ' P- <br /> -RY' <br /> Assigned to : EE0004045 TASIOPOULOS <br /> SITE ADDRESS: 10 W LORENZEN RD, TRACY APN : 23914004 <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 Sewer------- -- <br /> Name of P rve or Name of System <br /> SUMMARY OR COMMENTS: 9 yl ws �attt <br /> OYe <br /> (, o <br /> 10V V <br /> I recommend: Approval,® Denial Continuance Inspect--• <br /> _Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> SUPERVISOR/LEAD SENIOR Approval: 47V: - Date: ` l <br /> �QA 11 Check Off Lis • Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 August 29,2014 <br />