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•r. <br /> NOTE: PULL AL hRMITS (Septic, Well, etc.) MAKE.._OPIES FOR PILE <br /> LAND USE REPORT RECORD ID: SU0007924 <br /> DATE RECEIVED by EHD: September 28,2009 APPL#: PA-0900223 _ <br /> Referral Agency STAFF CONTACT: JOHN FUNDERBURG PE : 2631 <br /> SITE APPROVAL-MINOR(SA) <br /> COMPLETE & SUBMIT BY: Tue, October 20, 2009 <br /> Assigned to : E1:0004045 TASIOPOULOS <br /> SITE ADDRESS: 17722 EUGENIA AVE, RIPON APN: 24521029 <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 /> r� Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: <br /> _ <br /> I recommend: Approval 0- Denial Continuance Inspec <br /> ature <br /> Supervisor/Lead Senior COMMENTS: <br /> E <br /> I <br /> SUPERVISOR/LEAD SENIOR Approval: Date: L S C <br /> SOA Jl Ghei k i�fftst <br /> Proofread eport'? orr ,AND US1 ? <br /> .� <br /> zxeet C T I I1 N(S. s LoU$P,Boa <br /> EH 06 06 Report 47201 September 28,2009 <br />