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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE 6--b-PIES POR FILE <br /> LAND USE REPORT RECORD ID: SU0008707 <br /> DATE RECEIVED by EHD: April I1,2011 APPL#: PA-1100056 <br /> Referral Agency STAFF CONTACT: KEVIN SWANSON PE : 2622 <br /> SUBDIVISON-MINOR(MS) <br /> COMPLETE &SUBMIT BY: Tue, May 3, 2017 <br /> Assigned to : EE0005944 ESCOTTO <br /> SITE ADDRESS: 24650 N MACKVILLE RD, CLEMENTS APN : 02115008 26 <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: 69�6 �� _ f <br /> } <br /> = ✓ <br /> 576 / /4A, <br /> i ,I� : �i i�:c� = :az;� zzA Uz ��) � off. <br /> I recommend: Approval 2 Denial Continuance Inspecto <br /> Signature <br /> Supervisor/Lead'-Senior COMMENTS: <br /> j <br /> a..r <br /> 269 =D <br /> - <br /> (_ <br /> -Z-0 of ® Z <br /> O <br /> SUPERVISOR 1 LEAD SENIOR Approv l: Date: <br /> �,`..... f .ryf 1N. vwnrm•p(+q: ' "mpUlf �. <br /> DA t!Check Dff List d, - <br /> � � <br /> EH 06 06 Report 97201 April 12,2011 <br />