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NOTE: PULL AC6.�ERMITS (Septic, Well, etc.) MAKE-.-6PIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0008669 <br /> DATE RECEIVED by EHD: March 14,2011 APPL#: PA-1100040 <br /> Referral Agency STAFF CONTACT: RICK GRIFFINT PE : 2622 <br /> SUBDIVISON-MINOR(MS) <br /> COMPLETE& SUBMIT BY: Tue April 5, 2011 <br /> Assigned to : EE00040445 TASIOPOULOS <br /> X. <br /> SITE ADDRESS: 19912 E RIVE-W RI-PON APN : 24557000 0708 <br /> [n 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: <br /> C recommend: Approval Denial Continuance Inspe <br /> naturae-- <br /> SupervisorfLead Senior COMMENTS: <br /> o . <br /> Ft <br /> M <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> Pro6fr d Re o RE--N A If Gfteck C}ff iy ��' ,.., ,. 3 1' � C�r�eGtIAi`1)?.USE <br /> eab3.x'?' '�. °�. -F,P-,... & <br /> EH 06 06 Report N7241 March 14,2011 <br />