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r <br /> S j <br /> { <br /> NOTE: PULL A ERMITS (Septic, Well, etc,) MAK'"OPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0007799 <br /> DATE RECEIVED by EHD: June 26,2009 APDL#: PA-0900153 <br /> Referral Agency STAFF CONTACT: RICK GRIFFIN PE : 2625 <br /> USE PERMIT-MINOR(UP) <br /> COMPLETE&SUBMIT BY: Wed, July 75, 2009 <br /> Assigned to : EE0005366 MEDINA <br /> SITE ADDRESS: 100 E TADDEI RD, ACAMPO APN: 01313023 <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 /> / r <br /> /li aC� o tea/ <br /> �. <br /> I recommend: Approval Denial Continuance Insp ct <br /> i � ignature <br /> Supervisor/Lead Senior COMMENTS: <br /> iU <br /> Lb <br /> SUPERVISOR/LEAD SENIOR Approval: Date a?i <br /> �3,41J�ChecNt C?I f Lrst Poofrearl lteport? s -" -arreet LAS )I7 I -? f <br /> ..-.. _. Correct C4NDITIOhi(S Lbggeci an U 10 <br /> SE-Book? <br /> EH 06 06 Report 47201 July 02,2009 <br />