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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0012988 <br /> DATE RECEIVED by EHD: January 27,2020 APPL#: PA-2000003 Pre-Application <br /> Referral Agency STAFF CONTACT FRANK GIRARDI PE : 2625 <br /> USE PERMIT-MINOR(UP) <br /> COMPLETE&SUBMIT BY: Fri, February 7, 2020 <br /> Assigned to : EE0000418 KITH <br /> SITE ADDRESS: 54 W CONEJO CT , MOUNTAIN HOUSE APN: 25426048 <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: � � \A ti Public Sewer: <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: , � RL 1 0-ID � - <br /> J,Nc bl&g_ Sy�A, O�A a.-,-,o)4 � W LU., 16 k- 5.Nib l 6a,-r (-D (11-3 1J <br /> "T 6r- �1 S Ss� LA) - <br /> 117N�jLl)N 666 air"_ <br /> I recommend: Approval F] Denial F-1 Continuance ❑ Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> A 11 Check Off Li Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? - <br /> EH 06 06 Report#7201 January 28,2020 <br />