Laserfiche WebLink
MOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> RECORD ID: SU0004820 <br /> LAND USE REPORT <br /> DATE RECEIVED by EHD: February 08,2005 APPL#: PA-05-38 <br /> Referral Agency STAFF CONTACT: JOHN FUNDERBURG PE : 2690 <br /> u ilf- LOT LINE ADJUSTMENT(LA) <br /> COMPLETE&SUBMIT I <br /> Assigned to : EE0005366 MEDINA <br /> SITE ADDRESS- 18694 E ST RT 88 HWY, CLEMENTS APN : 01924054-,& <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 /> l^ <br /> ..ci- <br /> I recommend: Appro Denial El Continuance ❑ Ins ector: <br /> ignature _ <br /> Sooervisor/Lead Senior COMMENTS: <br /> D � <br /> 0 3 a <br /> c_ as;-0 <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> OA Y Check Off List: Proofread Report? Correct LAND USE#? 00, <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report 47201 Page 1 February 10,2005 <br />