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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0009102 <br /> DATE RECEIVED by EHD: March 16,2012 APPL#: PA-1200037 <br /> Referral Agency STAFF CONTACT: JO RBURG PE : 2690 <br /> LOT LINE ADJUSTMENT(LA) <br /> COMPLETE &SUBMIT BY: <br /> Assigned to : EE0004045 TASIOPOULOS <br /> SITE ADDRESS: 17576 E RIVER RD,RIPON APN : 24520010 <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 Purve or Name of System <br /> SUMMARY OR COMMENTS: <br /> G <br /> i <br /> �- I - <br /> t recommend: Approval DenialEl Continuance Inspec <br /> Sig ture <br /> Supervisor/Lead Senior COMMENTS: <br /> (770 Go <br /> SUPERVISOR/LEAD SENIOR Approval: Date: >- <br /> OA 11 Check Off List: Proofread Report? Correct LAND USE,#9 <br /> Correct CONDITION(S)? _ Logged in LAND USG Book' <br /> 11 06 06 N111nn=17"01 <br /> March 19,2012 <br />