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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0011070 <br /> DATE RECEIVED by ERD: October 03,2016 APPL#: PA-1000010 <br /> Referral Agency STAFF CONTACT: RICK GRIFFIN PE : 2631 <br /> SITE APPROVAL-MINOR(SA) <br /> COMPLETE&SUBMIT BY: Tue, October 18, 2016 A �Vr- ai PK--l n•1 <br /> Assigned to : EE0004045 TASIOPOULOS <br /> SITE ADDRESS: 12 W LORENZEN RD, TRACY APN : 23914003 <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: e-- Public Sewer: <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: l o/re/�6 S�c,�tfJ9 � ti d.�B 4 �j, •Z O l C� <br /> I recommend: Approval Denial Continuance Inspect <br /> nature <br /> Supervisor/Lead Senior COMMENTS: �f <br /> i <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> OA If Check Off List: Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> FH 06 06 Report#7201 October 04,2016 <br />