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NOTE: PULL ALL Pt-RMITS (Septic, Well, etc.) MAKE CU. IES FOR FILE <br /> LAND USE REPORT RECORD ID: S00008956 <br /> DATE RECEIVED by EHD: November 07,2011 APPL#: PA-1100208 <br /> Referral Agency STAFF CONTACT: JOHN FUNDERBURG PE : 2622 <br /> SUBWV ISON-MINOR(MS) <br /> COMPLETE& SUBMIT BY: Tue, December 6, 2077 <br /> Assigned to : EE0004045 TASIOPOULOS <br /> SITE ADDRESS: 19238 E HWY 120 ,RIPON APN : 24507024 35 <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 Purveyor Name of System <br /> SUMMARY OR COMMENTS: <br /> o .- <br /> it <br /> - \/\/ La, Pat ze,l <br /> � p�c.,l �2 �•cs vw � I l recommend: Approval O>Denial El Continuance Inspeeto <br /> store <br /> Supervisor/Lead Senior COMMENTS: <br /> it r i <br /> 2n tv v l Lk c l 3 z a 1 o <br /> L ( \.. L ; <br /> SUPERVISOR LEAD SENIOR Approval: i �- Date: ( 21 (— / / <br /> OA II Check Off List: Proofread Report? Correct LAND USE#? <br /> CoiTegt CONDITION(S)? 1.0gged in LAND USE Book? <br /> 8H 06 06 Report#7201 November o7,2011 <br />