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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0009369 <br /> DATE RECEIVED by EHD: October 0l,2012 APPL#: PA-1200189 <br /> Referral Agency STAFF CONTACT: JOHN FUNDERBURG PE : 2690 <br /> COMPLETE&SUBMIT BY: LOT LINE ADJUSTMENT(LA) <br /> u,•s b 1 C� �d � R�/� <br /> Assigned to: EE0004045 TASIOPOULOS <br /> SITE ADDRESS: 9951 W SUGAR RD, TRACY APN : 21216005 14 <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 Puurr���v///���yor Name of System <br /> SUMMARY OR MM NT � /�_, 1 .✓ <br /> or r <br /> 1 recommend: Approval Ege Denial Continuance Inspecto <br /> re <br /> Supervisor/Lead Senior COMMENTS, <br /> { O / <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> • g a)q4q <br /> 71 <br /> ,.,...s ..' ,., ._., <br /> 2H 06 06 Report#7201 <br /> October 01,2011 <br />