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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0012052 <br /> DATE RECEIVED by EHD: November 19,2018 APPL#: PA-1800286 Pre-Application <br /> Referral Agency STAFF CONTACT. CHRISTINE LUCKASEN PE : 2632 <br /> SITE APPROVAL-GENERAL(SA) <br /> COMPLETE&SUBMIT BY: Thu, November 29, 201 S <br /> Assigned to : EE0009488 WONG <br /> SITE ADDRESS: 11701 E BRANDT RD,LOCKEFORD APN: 05116024 <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 dire�(tii n, etc.... ^ I <br /> Public Water: / [�_ Publ'c Sewer: 1�/ ft-'j, <br /> Name of Purveyor k V�A // 09� Name o/flSystem <br /> SUMMARY OR COMMENTS: V r-\-k VI , • o �55.T .0Q /�t" 44. w�4! <br /> GQ, ?m /-lillQ' No � W a <br /> r t ]. <br /> �l I i S i iG %S <br /> to Ads C � P4 <br /> V <br /> C"ir - 2: o f 25 05 0 o f l� <br /> ll <br /> ; v-2 Z2 ;U /an <br /> I recommend: Approval ❑ Denial FJ Continuance Insp r: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: Q <br /> O <br /> f <br /> SUPERVISOR/LEAD SENIOR Approval: v Date: <br /> A B Check Off List., Proofread Report? V Correct LAND USE# <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report 47201 November 19,2018 <br />