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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0013029 <br /> DATE RECEIVED by EHD: February 10,2020 APPL#: PA-2000016 <br /> Referral Agency STAFF CONTACT! ALISA GOULART PE : 2632 <br /> SITE APPROVAL-GENERAL(SA) <br /> COMPLETE&SUBMIT BY: Thu, February 27, 2020 <br /> Assigned to : EE0000418 KITH <br /> SITE ADDRESS: 865 E ROTH RD,FRENCH CAMP APN : 19332026 <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: 410 / Public Sewer: A/011111/e <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: <br /> ��- <br /> r✓wRLv� b'� S <br /> I recommend: Approval ❑ Denial F-1 Continuance F-1 Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> SUPERVISOR/ LEAD SENIOR Approval: Date: <br /> OA II Check Off List: Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report 97201 February 12,2020 <br />