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NOTE;• PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0009317 <br /> DATE RECEIVED by EHD: August 13,2012 APPL#: PA-1200146 <br /> Referral Agency STAFF CONTACT: JOHN FUNDERBURG PE : 2622 <br /> SUBDIVISON-MINOR(MS) <br /> COMPLETE&SUBMIT BY: Tue, September 4, 2072 <br /> Assigned to: EE0005944 ESCOTTO <br /> SITE ADDRESS: 15495 E HWY 88 ,LOCKEFORD APN: 01917009 19 <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: -F/,6 � <br /> 7 <br /> • /�92/�r t!`i �ls.�—��,�h�:.r�y d� �/icEf�a�< <br /> ern=l�i� l2Cir�i�.crr�.�rs�i �a�� y c�c�LCs�2o< <br /> ti{7 L F1! cvL <br /> 6✓$7c lsy�� g=c ,✓!�'tE �a <br /> ,411 <br /> [ recommend: Approval DenialEl ContinuanceEl Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> r�Ll <br /> n �- <br /> ��5 i f 4 <br /> a i <br /> -OG � g--Aaa Ce <br /> SUPERVISOR/LEAD SENIOR Approval: Date: _ —t <br /> OA 11 Check Off List: Proofread Report? Correct LAND.USE 4 ? <br /> Correct CONDI'I10N(S)? Logged in LAND USE.13ook? <br /> EH 06 06 Report#7241 <br /> August ;,'01- <br />