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NOTE: PULL ALS RMITS (Septic, Well, etc.) MAKS PIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0007298 <br /> DATE RECEIVED by EHD: July 28,2008 APPL t#: PA-0800223 <br /> Referral Agency STAFF CONTACT: EVA PAGE PE : 2690 <br /> COMPLETE& SUBMIT BY: LOT LINE ADJUSTMENT(LA) <br /> Assigned to : EE0005366 MEDINA <br /> SITE ADDRESS: 12502E HARNEY LNv, L DI r APN : 06324012 <br /> i <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 Ins ecto <br /> � Si Dat re <br /> Supervisor/Lead Senior COMMENTS: <br /> SUPERVISOR/LEAD SENIOR Approval: Date• d <br /> Proofread Re ort <br /> O}i!l check iff S F Corree d NBU E#�? <br /> �o <br /> rr <br /> r. e. f C)II ITiLI t{S) m Logged ir�LAND t�SE Baulk <br /> EH 06 06 Report#7201 July 28,2008 <br />