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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0010260 <br /> DATE RECEIVED by EHD: October 10,2014 APPL#: PA-1400195 <br /> Referral Agency STAFF CONTACT: JOHN FUNDERBURG PE : 2690 <br /> r K rJ LOT LINE ADJUSTMENT(LA) <br /> COMPLETE& SUBMIT BY: € � , <br /> ri I - Assigned to : EE0004045 TASIOPOULOS <br /> SITE ADDRESS: 1175 S VECINDAD ST, MOUNTAIN HOUSE APN : 26202001 <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: , <br /> 1 recommend: Approval Denial Continuance F-1 Inspecto _ <br /> ure <br /> Supervisor/Lead Senior COMMENTS: <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> k Off List Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 October 15,2014 <br />