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SU0013133
EnvironmentalHealth
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SU0013133
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Last modified
12/7/2020 12:03:19 PM
Creation date
4/2/2020 2:21:44 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0013133
PE
2626
FACILITY_NAME
PA-1900036
STREET_NUMBER
19960
Direction
N
STREET_NAME
ELLIOTT
STREET_TYPE
RD
City
LOCKEFORD
Zip
95237-
APN
05121013, 05121070
ENTERED_DATE
4/2/2020 12:00:00 AM
SITE_LOCATION
19960 N ELLIOTT RD
RECEIVED_DATE
4/1/2020 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\sshih
Tags
EHD - Public
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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br />LAND USE REPORT RECORD ID: SU0013133 <br />DATE RECEIVED by EHD: April 01, 2020 <br />Referral Agency STAFF CONTACT' FRANK GIRARDI <br />COMPLETE & SUBMIT BY: Thu, April 30, 2020 <br />APPL #: PA -1900036 <br />PE : 2626 <br />USE PERMIT - GENERAL (UP) <br />Assigned to : EE0000418 KITH <br />SITE ADDRESS: 19960 N ELLIOTT RD, LOCKEFORD APN : 05121013, 05121070 <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: ( of, rLLIEC--oRo L5 jp <br />Name of Purveyor <br />Public Sewer: ( o LIGE" C -S •.a <br />Name of System <br />SUMMARY OR COMMENTS: � � cydst4 r" N <br />/1/U ,rif.Gl�}✓VGl E ,��/ d� .SiLO'it� T�y �, � o� Q Q�yLs��N •., ff <br />��� ��r.0 +c• Q,����r5� i,�l'i-5 P�.%C �1t�, ���� �Yicyt�.�C-i <br />I recommend: Approval Denial ❑ Continuance Inspector: <br />Signature <br />Supervisor/Lead Senior COMMENTS: <br />SUPERVISOR / LEAD SENIOR Approval: Date: % <br />A 11 h k Off List: Proofread Report? Correct LAND USE # ? <br />Correct CONDITION(S) ? Logged in LAND USE Book? <br />EH 06 06 Report #7201 April 02, 2020 <br />
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