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NOTE: `PULL ACIrPERMITS (Septic, Well, etc.) MAKE i OPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0008582 <br /> DATE RECEIVED by EHD: January 18,2011 APPL#: PA-1100005 <br /> Referral Agency STAFF CONTACT: MO HATEF PE : 2690 <br /> COMPLETE &SUBMIT BY: LOT LINE ADJUSTMENT(LA) <br /> -4S* ■ <br /> Assigned to : F-EO004045 TASIOPOULOS <br /> SITE ADDRESS: 19067 E HWY 120 , RIPON ■ APN : 20507064 65 <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: 2� ° <br /> 1/1�X <br /> - fy L r <br /> � W <br /> U %,I <br /> G <br /> 5 <br /> I recommend: Approval Denial Continuance Inspect <br /> Supervisor/Lead Senior COMMENTS: nature <br /> SUPERVISOR I LEAD SENIOR Appro al <br /> Date: <br /> /L /•� <br /> :. ��• � ;y�;. � -� Correcf CONDI�'���T(�)�7 ��> � �r .� � � �� �;:� ' � � ,.�; � �� F <br /> EH 06 06 Report 47201 <br /> January 18,2011 <br />