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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br />LAND USE REPORT RECORD ID: SU0010861 <br />DATE RECEIVED by EHD: April 18, 2016 <br />Referral Agency STAFF CONTACT: MEGAN E AGUIRRE <br />COMPLETE & SUBMIT BY: Wed, April 27, 2016 <br />APPL #: PA -1600046 <br />PE : 2631 <br />SITE APPROVAL - MINOR (SA) <br />Assigned to : EE0004045 TASIOPOULOS <br />SITE ADDRESS: 865 E ROTH RD, FRENCH CAMP APN : 19332016 <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 />Name of Purveyor Name of System <br />SUMMARY OR COMMENTS: 13 <br />s calf e.r <br />I recommend: Approval +;;-�j Denial Continuance <br />`� �j Signature <br />Supervisor/Lead Senior COMMENTS: J _ y <br />e 2 . <br />--L;-,r VA, <br />•tel <br />SUPERVISOR / LEAD SENIOR Approval: <br />EH 06 06 Report #7201 April 19, 201 <br />