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NOTE: PULL ALk cRMITS (Septic, Well, etc.) MAKE )PIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0008928 <br /> DATE RECEIVED by EHD: October 11,2011 APPL#: PA-1100182 <br /> Referral Agency STAFF CONTACT: JOHN L FUNDERBURG PE : 2690 <br /> LOT LINE ADJUSTMENT(LA) <br /> COMPLETE& SUBMIT BY: GAP <br /> Assigned to : EE0004045 TASIOPOULOS <br /> SITE ADDRESS: 14577 E FRENCH CAMP RD, RIPON APN : 20306004 08 12 <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: J Public Sewer: <br /> Name of Pury yor Name of System <br /> SUMMARY OR COMMENTS: ` 53 ' <br /> ttV. <br /> ONH <br /> � 1 <br /> a <br /> 1 <br /> I recommend: Approval ® Denial Continuance Inspect <br /> natur <br /> Supervisor/Lead Senior COMMENTS: <br /> d <br /> Jr <br /> St1PERVISOR/ LEAD SENIOR Approval: 1y _ - Date: b <br /> OA 11 Check Off List: Proofread Report?- Correct LAND USE# <br /> Correct CONDITIONS ? ' <br /> O Logged in LAND USE Book? <br /> EH 06 06 Report#7201 <br /> October 11,2011 <br />