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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0012251 <br /> DATE RECEIVED by EHD: April 02,2019 APPL#: PA-1900060 <br /> Referral Agency STAFF CONTACT TEDDIE HERNANDEZ PE : 2631 <br /> SITE APPROVAL-MINOR(SA) <br /> COMPLETE&SUBMIT BY: Thu, April 18, 2019 <br /> Assigned to : EE0009488 WO� <br /> SITE ADDRESS: 22420 N HWY 99 ,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: Nerti- Public Sewer: Non <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: <br /> I recommend: Approval Denial Continuance Inspector: <br /> Signature <br /> Sunervisor/Lead Senior COMMENTS: <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> h Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> GH 06 06 Report 47201 April 02,2019 <br />