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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0012704 <br /> DATE RECEIVED by EHD: December 16,2019 APPL#: PA-1900277 <br /> Referral Agency STAFF CONTACT FRANK GIRARDI PE : 2622 <br /> SUBDIVISON-MINOR(MS) <br /> COMPLETE&SUBMIT BY: Mon, December 30, 2019 <br /> Assigned to : EE0000418 KITH <br /> SITE ADDRESS: 3500 S MOUNTAIN HOUSE PKWY,MOUNTAIN APN : 20906049,20906050 <br /> TTOUSE <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: SO Public Sewer: <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: <br /> k7 rjj- <br /> S .CF V sm�C ARI 0 i tALV(A 0�A L.c�►` <br /> r JU1.�PsL�c- �" s NQS VL'���C.'� (,fS 1.?�• f'1 F�L��� 1 /�"�%�'�1 I�� VI,C�G���1 <br /> I recommend: Approval F-1 Denial F-1 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 December 17,2019 <br />