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a - <br /> NOTE: PULL ALL i.—AMITS (Septic, Well, etc.) MAKE G-MES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0005661 <br /> DATE RECEIVED by EHD: October 05,2005 APPL#: PA-030004$TE <br /> Referral Agency STAFF CONTACT: JOHN FUNDERBURG PE : 2690 7� <br /> COMPLETE& SUBMIT BY: LOT LINE ADJUSTMENT(LA <br /> ��� <br /> Assigned to EE0009644 ESTRADA <br /> SITE ADDRESS: 25992 N ELLIOTT RD, GALT APN : 00722005& 11 <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 /> I recommend: Approval F-1 Denial Continuance Inspector: <br /> Signature <br /> Sunervisor/Lead Senior COMMENTS: <br /> SUPERVISOR 1 LEAD SENIOR Approval: Date: l e d <br /> Proofread"fiort? -Correct LAND USE4#7 <br /> OA!1 Check OffList: P. <br /> Correct CONpI.TION(S)7 Logged in LAND USE Book? <br /> EH 06 06 Report 47201 October 06,2005 <br /> i <br />