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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0010206 <br /> DATE RECEIVED by EHD: August 18,2014 APPL#: PA-1400131 <br /> Referral Agency STAFF CONTACT: JOHN FUNDERBURG PE : 2656 <br /> REVISIONS TO ACTIONS (RA) <br /> COMPLETE&SUBMIT BY: Mon, September 8, 2014 <br /> Assigned to : EE0004045 TASIOPOULOS <br /> SITE ADDRESS: 541 WICKLUND CROSSING , MOUNTAIN HOUSE APN : 25403004 <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: VPublic Sewer: <br /> ame of Purveyor Name of System <br /> SUMMARY OR COMMENTS: <br /> I recommend: Approval El Denial Continuance Inspector�i <br /> ignature <br /> Supervisor/Lead Senior COMMENTS: <br /> SUPERVISOR/LEAD SENIOR Approval: Date: 1), <br /> OA If Check Off List: Proofread Report? Correct LAND USE 4? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 August 29,2014 <br />