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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0011767 <br /> DATE RECEIVED by EHD: April 25,2018 APPL#: PA-1800004 <br /> Referral Agency STAFF CONTACT JOHN FUNDERBURG PE : 2632 <br /> SITE APPROVAL-GENERAL(SA) <br /> COMPLETE& SUBMIT BY: Fri, April 27, 2018 <br /> Assigned to: EE0000034 AHMED <br /> SITE ADDRESS: 825 S STERLING DR, MOUNTAIN HOUSE APN : 25405006 THROUGH <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 /> I recommend: Approval ❑ Denial ❑ Continuance ❑ Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> Lam. <br /> SUPERVISOR/ LEAD SENIOR Approval: Date: <br /> Il h k ff List: Proofread Report? Correct LAND USE# <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report 47201 April 25,2018 <br />