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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> -AND USE REPORT RECORD ID: 5000098;9 <br /> DATE RECEIVED by EHD: December 19,2013 APPL#: PA-1300007 <br /> Referral Agency STAFF CONTACT: CORINNE KING PE : 2631 <br /> SITE APPROVAL-MINOR(SA) <br /> COMPLETE&SUBMIT BY: Tue, January 7, 2014 <br /> Assigned to : EE0004045 TASIOPOULOS <br /> SITE ADDRESS: 865 E ROTH RD, FRENCH CAMP APN : 19332016 <br /> .n completing the Land Use investigation, draw all Public Health factors on the exhibit (i.e., sewage disposal, water <br /> ;upplies, etc...). Where necessary, on an attached piece of plain paper, draw complete map of area showing population <br /> Tensity, location of house, wind direction, etc.... - <br /> Public Water. - Public Sewer: <br /> Name of Purveyor Name of System <br /> >UMMARY OR COMMENTS: � �jy 000 953 5 /sem <br /> iv <br /> ------------ <br /> recommend: Appro%A Denial Continuance Inspect - <br /> ;upenisor/Lead Senior COMMENTS: <br /> Cb ha w.,t <br /> r <br /> US ' <br /> 4 PERVISOR; LEAD SENIOR Apprm al: Date: <br /> OA 1!Check Off List: Proofread Report' Correct LAND USE#? <br /> Correct UONDFHON(S)'' Logged in LAND USE Book? <br /> December 20,2013 <br />