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NOTE: PULL ALOCRMITS (Septic, Well, etc.) MAKE IES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0006248 <br /> DATE RECEIVED by EHD: September 12,2006 ADPL#: SA-000011 <br /> Referral Agency STAFF CONTACT: RICK GRIFFIN ------ <br /> PE : 2656 <br /> i <br /> COMPLETE& SUBMIT Wed September 27, 2006 <br /> BY: REVISIONS TO ACTIONS (RA) <br /> • <br /> Assigned to : EE0007379 BOERTIEN <br /> SITE ADDRESS: 7621 S LOCKHART RD,FRENCH CAMP APN : 19318088 <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: /V /7 Public Sewer: I///-I <br /> ' <br /> SUMMARY OR COMMENTS:Name of Purveyor Name of System <br /> I recommend: Approval Denial Continuance El Inspector: <br /> Supervisor/Lead Senior COMMENTS: Signature <br /> D <br /> L c'3 4-- s <br /> u.L tea.'�+ Gti.- v��E�* �e'�•e t�w cW t �-f `f'�.�_ �•G2 c.-E..- "+� Q r"�fz Wr C,I <br /> �- �r t � a_4 d rM e� w�c-� a..-s� cc •�o a.�� . �` cx eaLr��„ � <br /> r _ SQ _t.t• ot�i � � � r�. (ate_aKct '�•� <br /> !. e Ca'�cam... Lt,)(tA-..�- '� wt- �S et r t Gwf vwr ✓'�►.e r.. `� ,_ �� <br /> SUPERVISOR/LEAD SENIOR Approval: Date: g (� <br /> D `ll'CpFa6W'Reparr7 A <br /> Y: — <br /> �. AND iJu Books <br /> ,. <br /> A <br />,H 06 06 Report 47201 <br /> September 13,2006 <br />