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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0011953 <br /> DATE RECEIVED by EHD: September 17,2018 APPL#: PA-1700257 <br /> Referral Agency STAFF CONTACT FRANK GIRARDI PE : 2690 <br /> LOT LINE ADJUSTMENT(LA) <br /> COMPLETE&SUBMIT BY: Fri, September 21, 2018 <br /> Assigned to : EE0000034 ARMED <br /> SITE ADDRESS: 1248 S TIVOLI LN, MOUNTAIN HOUSE APN: 26226006,26226007,26226008 <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: Ve,,,,4, Public Sewer: 41e*y <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: <br /> s-�c ✓r 3�`t' �/i s/i�—� No seJ6a�,✓,�s I+✓�`'1 o.ti Ti '✓aC, ' Lc,�c y e-�- <br /> �s �r sSSSrs?#N^ ej.4 1 ��.. <br /> en-� <br /> I recommend: Approval 171Denial ❑ Continuance Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> SUPERVISOR/LEAD SENIOR Approval: ��, ,� Date: <br /> OA 11 Check Off List: Proofread Report? Correct LAND USE#'? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 September 19,2018 <br />