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NOTE: PULL ALL�PaRMITS (Septic, Well, etc.) MAKE CVt IES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0008599 <br /> DATE RECEIVED by ERD: January 28,2011 APPL#: PA-1100016 <br /> Referral Agency STAFF CONTACT: RICK GRIFFIN PE : 2690 <br /> LOT LINE ADJUSTMENT(LA) <br /> COMPLETE & SUBMIT BY: A6APe <br /> Assigned to : EE0044045 TASIOPOULOS <br /> SITE ADDRESS: 14280 E HWY 120 , RIPON APN : 24503020 <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 rvey r Name of System <br /> SUMMARY OR COMMENTS: a> n,* u— <br /> f , <br /> A <br /> [ recommend: Approval w Denial Continuance ❑ Inspe Owl— _ <br /> • ignature <br /> Supervisor/Lead Senior COMMENTS: <br /> CA cryx <br /> SUPERVISOR/LEAD SENIOR Approval: Date: Y� Ll <br /> } a _ <br /> 0�4 Il Check Off Lrsf Proofread Report �t-- R � ��� <br /> € x ", 'a: e€8'.. °` `' E.,:ts.;"`"�' €c.�'' .... .l`= -gyrus_ :as i <br /> € CarreetS7N17IT3(�N(S) Lp ed> <br /> .• :, ga <br /> EH 06 06 Report 97201 January 31,241 l <br />