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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0009662 <br /> DATE RECEIVED by EHD: June 12,2013 APPL#: PA-1300087 <br /> Referral Agency STAFF CONTACT: STEPHANIE STOWERS PE: 2622 <br /> SUBDIVISON-MINOR(MS) <br /> COMPLETE&SUBMIT BY: Tu-�, Z 1 Z� ?� Assigned to : EE0005944 ESCOTTO <br /> SITE ADDRESS: 24226 E HWY 4 RD, FARMINGTON APN : 18711020 <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 /> C�5/Q<G['i1l�Ginr� <br /> /�l6-ih5f.3l�Lr.[�LL�llcif- <br /> 4#�_tats Tn ia&nAA4,4:s& <br /> aL ,J�; 4-&W. <br /> I recommend: Approval © Denial Continuance Inspect <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> 1/_4�Aek- I 241L,�7F3LD1,P6 dS75 4,PE�2LL-Z1S+7!aqy 7613 <br /> 10-C7W s �y <br /> F311 7 <br /> 1Z (�) ��=cY2 r 1�) 7 Z 31 tp'464ig!±z4 ) :) Z,7 �,Oj <br /> - <br /> �a /3 . <br /> 2 — th1 Ccwol v t . <br /> VveA <br /> T��^ V✓� wu.> po�t./ h(,aJ „y, a ,t.w.�o r"/:y ni„Nk„/' �►- z '-1Z5'ry� d al��'i <br /> UPERVISOR/LEAD SENIOR Approval: lLVl - /X41 /Yt— Date: -7/ 2- 113 <br /> OA 11 Check Off List: Proofread:Report? Correct LAND USF.#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 <br /> June 12,201'_ <br />