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I <br /> NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD 1D: SU0008939 <br /> DATE RECEIVED by EHD: October 20,2011 APPL#: PA-1100188 <br /> Referral Agency STAFF CONTACT: JO N R PE : 2690 <br /> LOT LINE ADJUSTMENT(LA) <br /> COMPLETE&SUBMIT BY: <br /> Assigned to : EE0005944 ESCOTTO <br /> SITE ADDRESS: 3443 N DRY CREEK RD, GALT APN : 00907001 <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: Ike--(/ i Z—"a <br /> • /�.42C:� '�/ �����• '� �) i7Es� -�..,er � T.K �4 k gP� �vs�tT� � �Y»1�sze� c.e-�e <br /> f31 i�e -'� �! Q Aee2s <br /> 4 5 f?2—"—�Z A�Z c'c-r�5zs7r� f <br /> kt; e<6�G C7L Z./Z' Cc T /5<t!tom l< G6t/L 1 ✓Ls�Ir".rl7i� <br /> Z22=!L � <br /> ' ! ) �.r �/ft ��'/7]E ''� //Zi epi✓/)/�L�" ^� 1112. 47 Cg..Gl�ite=. 75 ///y .T c3cJ ZiyvS <br /> 1 recommend: Approval 51/ Denial F1 Continuance Inspector <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> e� C nV n <br /> SUPERVISOR/LEAD SENIOR Approval: Dale: <br /> lc <br /> OA 11 Check Off List: Proofread Report? Correct LAND USE N? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> Ell 06 06 Report 47201 October 20,2011 <br />