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SU0011423
Environmental Health - Public
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EHD Program Facility Records by Street Name
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T
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12 (STATE ROUTE 12)
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8803
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2600 - Land Use Program
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PA-1700140
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SU0011423
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Entry Properties
Last modified
11/19/2024 3:48:16 PM
Creation date
9/9/2019 10:27:41 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0011423
PE
2690
FACILITY_NAME
PA-1700140
STREET_NUMBER
8803
Direction
E
STREET_NAME
STATE ROUTE 12
City
VICTOR
Zip
95240-
APN
05139013
ENTERED_DATE
7/18/2017 12:00:00 AM
SITE_LOCATION
8803 E HWY 12
RECEIVED_DATE
7/17/2017 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\T\HWY 12\8803\PA-1700140\SU0011423\APPL.PDF \MIGRATIONS\T\HWY 12\8803\PA-1700140\SU0011423\CDD OK.PDF \MIGRATIONS\T\HWY 12\8803\PA-1700140\SU0011423\EHD COND.PDF \MIGRATIONS\T\HWY 12\8803\PA-1700140\SU0011423\EHD PERM.PDF
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EHD - Public
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�0% <br /> NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FI <br /> LAND USE REPORT RECORD ID: SU0011423 <br /> DATE RECEIVED by EHD: July 17,2017 APPL#: PA-1700140 <br /> Referral Agency STAFF CONTACT' RICK GRIFFIN PE : 2690 <br /> LOT LINE ADJUSTMENT(LA) <br /> COMPLETE & SUBMIT BY: Fri, July 21, 2017 <br /> Assigned to : EE0005944 ESCOTTO <br /> SITE ADDRESS: 8803 E HWY 12 ,VICTOR APN : 05139013 <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: _At 4L: <br /> ' /�7��/ �isbit/� ff l��/✓✓�-y/�f G/lJL/A./�ILc ��tii SYSZ6'/�5/7f'GGEZf�s <br /> - �Z ��.4•a�-�f-/�.4��K�fbE_,73GDG 'Sr�'?!G 9f6 Z�3✓1 ,�f�AG /.rsk7_D'1, <br /> • �c-YJ/i.,�lL �- L161- �E%�S�tc�G� iV G��C�/LE7P7 <br /> 4ZW L2 h) :ors U9 62n4 — ez AeI6 444, <br /> 7 / <br /> I recommend: Approval Denial Continuance Inspector <br /> Signature <br /> Su ervisor/Lead Senior COMMEN S: <br /> SUPERVISOR/LEAD SENIOR Approval: Date <br /> All h LW7 Proofread Report? Correct LAND USE 9') <br /> Correct CONDITION(S)? Logged in LAND US Book? <br /> EH 06 06 Report#7201 July 18,2017 <br />
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