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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0006493 <br /> DATE RECEIVED by EHD: April 03,2007 APPL#: PA-0700127 <br /> Referral Agency STAFF CONTACT: ANTONIO SALCEDO PE : 2690 <br /> LOT LINE ADJUSTMENT(LA) <br /> COMPLETE',&SUBMIT BY: ASARBY <br /> Assigned to : EE0005366 MEDINA <br /> SITE ADDRESS: 23553 N MACKVILLE RD, CLEMENTS APN : 01922035 36 <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: y� <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: <br /> 6I06- <br /> I <br /> recommend: Approval E--benial F-1 Continuance Inspec -_ <br /> Sig iature <br /> Supervisor/Lead Senior COMMENTS: <br /> SUPERVISOR/LEAD SENIOR Approval: ate: <br /> OA 11 Check Off List: Proofread Report? Correct LAND USE#? <br /> . Correct CONDITION(S)? Logged in LAND USE Book? <br /> I <br />