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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0012165 <br /> DATE RECEIVED by EHD: February 01,2019 APPL#: PA-1800204 <br /> Referral Agency STAFF CONTACT CHRISTINE LUCKASEN PE : 2631 <br /> SITE APPROVAL-MINOR(SA) <br /> COMPLETE& SUBMIT BY: Thu, February 28, 2019 <br /> Assigned to : EE0009488 WONG <br /> SITE ADDRESS: 12505 E BRANDT RD, LOCKEFORD V rk-05y APN : 05132010 <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....V <br /> Public Water: / �-� Public Sewer: /\J <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: � ���7 � ; Z4—A ^ L — -� I� <br /> Z r CTS L <br /> 05 � -col <br /> 2 0 Y ��I c <br /> L - Qs cams w/ Mt <br /> xrc ' k <br /> 2 .� n CoA te S2ML rnaw� 4cL s� <br /> t b rAwk 21AIN. <br /> I recommend: ApprovafH befflal El Continuance Ins ector: <br /> Signature <br /> Suljervisor/Lead Senior COMMENTS: <br /> rw <br /> s !� <br /> !Js n! 13 AAA1Q <br /> do zZ 3L nJ <br /> er ' �s <br /> Sks r <br /> .r- 0 Lt o o 3W-3 �n 2cot or /' 2008 . <br /> 7 v-j,v% � 4 r-G-Arc'r 2 fPL01rVVNa, yn rx 2Dc�i p <br /> P - ©©o t 3 I-im <br /> 0 Q - I -6- 60 <br /> le 52 <br /> ifI (a �3 a <br /> SUPERVISOR/LEAD SENIOR Approval: / Date: <br /> OA II Check Off List: Proofread Report? Y Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report 47201 February 05,201 <br />