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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0013459 <br /> DATE RECEIVED by EHD: July 01,2020 APPL#: PA-2000092 <br /> Referral Agency STAFF CONTACT JOHN FUNDERBURG PE : 2637 <br /> SPECIAL PURPOSE PLAN(PP) <br /> COMPLETE&SUBMIT BY: Wed, July 22, 2020 <br /> Assigned to: EE0000418 KITH <br /> SITE ADDRESS: 19629 S MOUNTAIN HOUSE PKWY, MOUNTAIN APN: 25455029,-21,-22,-23,-24, <br /> TTOUSE > > <br /> -30 <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: Rlyel SD Public Sewer: /llr�csl� <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: <br /> - S�ft �� '-i � T Ki��//J/t/�sI q � �F.n ✓h �A+d fl.i d.- <br /> I recommend: Approval ❑ Denial F-1 Continuance ❑ Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> OA 11 Check Off List: Proofread Report? Correct LAND USE#? <br /> dommidilk Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 July 06,2020 <br />