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NOTE: PI ,,JALRMITS (Septic, Well, etc.' AK FOR FILE <br /> LAND IJSE REPORT RECORD ID: SU0007857 <br /> DATE RECEIVED by EHD: August 06,2009 APPL#: PA-0900181 Pre-Application <br /> Referral Agency STAFF CONTACT: CORINNE KING PE : 2691 <br /> GP AMENDMENT 10+acres(GP) <br /> COMPLETE& SUBMIT BY: Wed, August 26, 2009 <br /> Assigned to : EE0005944 ESCOTTO <br /> SITE ADDRESS: 1.7754 N HWY 88 , LOCKEFORD APN : 05125010 <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 Natxie of System <br /> SUMMARY OR COMMENTS: w • <br /> J uQ c errs <br /> I recommend, Approval �' Denial � Continuance � Inspector. <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> i� <br /> - C C <br /> SUPERVISOR/LEAD SENIOR Approval Date <br /> "Iar�ftdR` n <br /> OA 11Ohecltf�ff Lift rte Lorre L mm -21 <br /> - _ <br /> vxQ AIN v, <br /> EH 06 06 Report 47261 <br /> August 10,2009 <br />