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NOTE: PULL ALL kiRMITS (Septic, Well, etc.) MAKE IES FOR FILE <br /> LAND USE REPORT RECORD ED: SU0006112 <br /> DATE RECEIVED by EHD: duly 07,2006 APPL#: PA-0600379 <br /> Referral Agency STAFF CONTACT: MO HATEF PE : 2622 <br /> SUBDIVISON-MINOR(MS) <br /> COMPLETE&SUBMIT BY: Wed, August 2, 2006 <br /> Assigned to : EE0005366 MEDINA <br /> SITE ADDRESS: 26076 N MACKVILLE RD, CLEMENTS APN : 02116017 <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 <br /> 0 <br /> i <br /> "aa. nz, <br /> I recommend: Approval Denial El Continuance Ins cto <br /> S gnature <br /> Supervisor/Lead Senior COMMENTS: <br /> I <br /> �1 o d�✓o�a " 00✓a'f'r . rJ/U.001+a/ c-�. a ..c! Cc�r{yv...r.... uK s <br /> ..d✓c0,✓ /`2 coda-�i � �a.•c.t� t-e <br /> 11.E <br /> 2-2 :O 4J <br /> C If 03 eL <br /> E . 2oo s o Z <br /> SUPERVISOR/LEAD SENIOR Approval: Date: /? p[, <br /> OA CcOffList: ProofreadReport? CorrecIANFMKfi? <br /> _ <br /> Correct CONDI:ION(S)? ' . bogged in`LAND USF Eook? <br /> EH 06 06 Report 117201 July 10,2006 <br />