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t <br /> NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> -LAND USE REPORT <br /> RECORD ID. SU0006230 <br /> DATE RECEIVED by EHD: August 31,2006 ADPL#: PA-0500509 REV <br /> Referral Agency STAFF CONTACT: MO HATEF <br /> PE : 2611 <br /> 7 <br /> COMPLETE&SUBMIT BY: p SUBDIVISION-MAJOR(SU) <br /> Wed! September '13, 2006 <br /> ` Assigned to : EE0005366 MEDINA <br /> SITE ADDRESS: 14400 E HWY 88 ,LOCKEFORD APN : 01911026 20 12 <br /> In completing the Land Use investigation, draw all Public Health factors on the exhibit (i.e., sewage. Where necessary, disposal, water <br /> supplies, etc... p ' <br /> ry, 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 /> N <br /> I� - <br /> I recommend: Approval Denial ❑ Continuance El In <br /> Si nature <br /> Su ervisar/Lead Senior COMMENTS: <br /> C] <br /> f <br /> i <br /> f <br /> rr z, <br /> SUPERVISOR/LEAD SENIOR Approval: __ Date: (�fo <br /> -. �.. <br /> t I <br /> EH 06 06 Report#7201 <br /> August 3l,2006 <br />