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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0011064 <br /> DATE RECEIVED by EHD: September 19,2016 APPL#: PA-1600194 <br /> Referral Agency STAFF CONTACT: MEGAN E AGUIRRE PE : 2626 <br /> USE PERMIT-GENERAL(UP) <br /> COMPLETE&SUBMIT BY: Tue, October 4, 2076 <br /> Assigned to: EE0005944 ESCOTTO <br /> SITE ADDRESS: 22420 N HWY 99 /W FRONTAGE RD, ACAMPO APN : 01319005 <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: ALJ G / Public Sewer: <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: 16- <br /> • r� Fafz�zsic.�zif�sizes cis<sz'� z�t�y-�/ �,�� _ �y. <br /> l //:��,?L //.'4S .Q1 1/L3K- Z )7Z.' U� Gi Z2 : � 6) /i7:y/ Ef)01:e3 <br /> I recommend: Approval IJ Denial ❑ Continuance Inspecto . <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> I <br /> I%o b <br /> p) n= 03 (�) <br /> �) tiz:0 <br /> 2'-n <br /> la) ISI " ot <br /> kt) tllZ=a� <br /> s) Io1:nT <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> A 11 h k ff List: Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report 07201 September 21,2016 <br />