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r <br /> " NOTE: PULL AL�. �RMITS (Septic, Well, etc.) MAKE SPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0008296 <br /> DATE RECEIVED by EIID: June 07,2010 APPL#: PA-1000119 <br /> Referral Agency STAFF CONTACT: KEVIN SWANSON PE : 2631 <br /> SITE APPROVAL-MINOR(SA) <br /> COMPLETE&SUBMIT BY: Tue, July G, 2010 <br /> Assigned to : EE0005366 MEDINA <br /> SITE ADDRESS: 13320 E HWY 88 , LOCKEFORD APN : 01902020 <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 Denial ❑ Continuance F-1 Insp <br /> Sig ature <br /> Supervisor/Lead Senior COMMEt4s: <br /> SUPERVISOR/ LEAD SENIOR Approval: Date: (/ <br /> ,..;. d K,a x ry rrc <br /> Aill check"O"ff Lrsf 'a s ',,Proofread Report a; a" s . ' U j Gozxeet A 1I74USI #:? -gpp "tt R0,103 t 'iia ; <br /> „''>l i! u a F i°� a�t „ t t� ,.s;{ t , } r k! <br /> 1 �, `: `,;e3y <; 'CorrectCONI)] IOE� " �s$ �LDggednL4NDU511Book? <br /> EH 06 06 Report 47201 June 08,2010 <br />