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NOTE:aPULLAL( :RMITS.(Septic, Well, etc.):1MAKE___/PIES,FORFILE <br /> LAND USE REPORT <br /> RECORD ID: SUG008298 <br /> DATE RECEIVED by EHD: June 07,2010 APPL#: PA-1000120 <br /> Referral Agency STAFF CONTACT:",,RICK GRIFFIN PE : 2690 <br /> LOT LINE ADJUSTMENT(LA) <br /> COMPLETE&SUBMIT BY: A S x R B-Y' <br /> Assigned to : EE0005366 MEDINA <br /> SITE ADDRESS: 15701 E HWY 88 , LOCKEFORD APN : 01917001 02 06 <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 Inspector: <br /> ignature <br /> Supervisor/Lead Senior COMMENTS: <br /> 1 <br /> SUPERVISOR 1 LEAD SENIOR Approval: Date: <br /> �,! +PR -E ili t y ,,•;; s ,. <br /> �N A r'O'ofread Re ort` ' . r r�� [ Gc�rreel l ANIS U5E`�F ��... <br /> 7,14 <br /> M.+ . . <br /> 3 j 'r � Corr�ct COl�7DI tiON }-� ,� ��° bogged�n)AND USS 1ook� <br /> "'..:,'Ia�i? .a ,� �Ed$i 4T.. ..td., <br /> EH 06 06 Report 47201 June 08,2010 <br />