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NOTE: PULL AL ERMITS (Septic, Well, etc.) MAK,_-OPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0007433 <br /> DATE RECEIVED by EHD: October 17,2008 APPL#: PA-0800329 <br /> Referral Agency STAFF CONTACT: MO HATEF PE : 2631 <br /> SITE APPROVAL-MINOR(SA) <br /> COMPLETE & SUBMIT BY: Tue, November 4, 2008 <br /> Assigned to : EE0005366 MEDINA <br /> SITE ADDRESS: 24876 N SUTTENFIELD RD, ACAMPO APN : 02104316 <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 Svstem <br /> SUMMARY OR COMMENTS: <br /> oc <br /> I recommend: Approval enial ❑ Continuance Ins ecto <br /> Sig aturc <br /> Supervisor/Lead Senior COMMENTS: <br /> SUPERVISOR 14 \D.SYN10R Alipro%al: ,. Date: <br /> OA 1l Check Off List: Proofread Report'' Correct I AND USF.4—.1- <br /> Correct <br /> .1Correct CONIATION(S)? Logged in LAND USE,Book? - -- <br /> 1A U6 06 Report 117201 <br />