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NOTE: PULL ALLRMITS (Septic, Well, etc.) MAKE OPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0007297 <br /> DATE RECE I V LI) by EHD: July 28,2008 APPL#: PA-0800183 <br /> Referral Agency STAFF CONTACT: PATRICK CROSBY PE : 2631 <br /> SITE APPROVAL-MINOR(SA) <br /> COMPLETE & SUBMIT BY: Wed, August 13, 2008 <br /> Assigned to : EE0005366 MEDINA <br /> SITE ADDRESS: 3819 E WOODBRIDGE RD, ACAMPO APN : 01321029 <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: z ,y� Public Sewer: <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: ff ' —5,—,4, <br /> 04 <br /> 10:08 <br /> 11:07 Prior to Final Occupancy <br /> 22:02 Prior to Final Occupancy <br /> 11:05 Delete parishoners <br /> 11:03 (a) Prior to Final Occupancy <br /> 22:04 Delete first sentence, start with should the number..... <br /> 203:02 <br /> 102:03 <br /> 102:04 <br /> I recommend: Approval U Denial U k-ontmuance U ins ecto <br /> gnature <br /> Supervis <br /> o <br /> r/Lead Senior COMMENTS: <br /> ( �l 1 o 0S <br /> �1I 1 0 -7 P, ,v s v �, 3 <br /> - LIZ— <br /> Erb <br /> LT <br /> SUPERVISOR/LEAD SENIOR Approval: z _ _- Date: ) <br /> OA/l Check Off List: Proofread Report?- Correct LAND USE# .' <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report 97201 �i,�y 18,2008 <br />