Laserfiche WebLink
i <br /> NOTE: PULL ALL RMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> _AND USE REPORT RECORD ID: SU0008068 <br /> DATE RECEIVED by EHD: January 25,2010 APPL#: PA-0900260 RE <br /> Referral Agency STAFF CONTACT: MO HATEF PE : 2631 <br /> SITE APPROVAL-MINOR(SA) <br /> COMPLETE& SUBMIT BY: F , ,�o <br /> -- Assigned to : EE0005366 MEDINA <br /> SITE ADDRESS- 22275 N TRETHEWAY RD, ACAMPO APN : 01726044 <br /> n 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 /> lensity, location of house, wind direction, etc.... <br /> Public Water: Public Sewer: <br /> Name of Purves or Name of System _ <br /> ;UMMARY OR COMMENTS: <br /> recommend: Approval Denial Continuance Inspe �c <br /> Sign ture <br /> unervisor/Lead Senior COMMENTS: <br /> E <br /> If <br /> I <br /> UPERVISOR/LEAD SENIOR Approval: ate: Ci <br /> r <br /> OA!!.Check Off List: Proofread Report. &mr t.LAND USE#? <br /> Correct CONDITIONS)? l,pgged iri'LAND USE,Book? <br /> 1-106 06 Report 47201 January 25,2010 <br />