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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0010586 <br /> DATE RECEIVED by EHD: August 10,2015 APPL#: PA-1500141 <br /> Referral Agency STAFF CONTACT: CORINNE KING PE : 2690 <br /> LOT LINE ADJUSTMENT(LA) <br /> COMPLETE& SUBMIT BY: —ASAPH Assigned to : EE0005944 ESCOTTO <br /> SITE ADDRESS: 28539 N MACKVILLE RD, CLEMENTS APN : 00909004 00912 03"O0 <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 /> � Jie,i fz2�� matt n <br /> bl4f%z 3 c� -Vn. s .4 GJi7.11 4 <br /> 1-42&=!:� <br /> I recommend: Approval �y ' Denial F-1 Continuance F-1 Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> SUPERVISOR/LEAD SENIOR Approval: Date: r <br /> k Off List: Proofread Report? Correct LAND USE#'?_ <br /> Correct CONDITION(S)? Logged in LAND USE Book'? <br /> EH 06 06 Report#7201 August 10,2015 <br />