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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0011118 <br /> DATE RECEIVED by EHD: November 14,2016 APPL#: PA-1600260 <br /> Referral Agency STAFF CONTACT: EVAN WATSON PE : 2690 <br /> A LOT LINE ADJUSTMENT(LA) <br /> !lllll <br /> Q7&i A ft f tT BY: Fri, November 18, 2018 <br /> \J Assigned to : EE0005944 ESCOTTO <br /> SITE ADDRESS: 26192 N MACKVILLE RD, CLEMENTS APN : 02116042 <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: _ 7 <br /> IrlLJ / - � �� ���� <br /> Z A� i4n✓i <br /> �!(�C DLGJI? LiKZcsISS[/r� IZ2) <br /> AJ <br /> I recommend: Approval Denial Continuance Inspec or - <br /> Signature <br /> Suoervisor/Lead Senior COMMENTS: <br /> Ub <br /> SUPERVISOR/ LEAD SENIOR Approval: Date: ' <br /> A II Check Off List: proofread Report'? Correct LAND USF#'? <br /> Correct CONDITION(S)? Logged in LAND USE Book'? <br /> 1'1 1 06 06 Report 47201 Kovemher 1< '01h <br />