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cal <br /> NOTE: PULL ALL'V eAMITS (Septic, Well, etc.) MAKE ". PIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0006289 <br /> DATE RECEIVED by EHD: October 03,2006 APPL#: PA-0600537 <br /> Referral Agency STAFF CONTACT: JOHN FUNDERBURG PE : 2690 <br /> LOT LINE ADJUSTMENT(LA) <br /> COMPLETE& SUBMIT BY: A S A R BY: <br /> Assigned to : EE000366 MEDINA <br /> SITE ADDRESS: 16880 E HWY 88 , LOCKEFORD APN : 01918031 <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: /d�y <br /> I recommend: Approval Denial F-1Continuance In r: <br /> S gnature <br /> SS"ervisor/Lead Senior COMMENTS: <br /> SUPERVISOR/LEAD SENIOR Approval: Date: l0 Wo& <br /> EH 06 06 Report#7201 October 03,2006 <br />