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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0009424 <br /> DATE RECEIVED by EHD: November 26,2012 APPL#: PA-1200229 <br /> Referral Agency STAFF CONTACT: RICK GRIFFIN PE : 2690 <br /> LOT LINE ADJUSTMENT(LA) <br /> COMPLETE &SUBMIT BY: <br /> Assigned to : EE0005944 ESCOTTO <br /> SITE ADDRESS: 19255 E MEHRTEN RD, CLEMENTS APN : 02302008 <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: _F <br /> In <br /> C Sr7t�Jt�54 71� ' C, <br /> #z ,4+ c�cF i+ cdn��l z leqC7�i �/r< �„ c<t� ✓rte +r o <br /> / A_.,rj <br /> '6D u4L L C-W G-iia /�.b7 155irr3 GC cat��Jt�tzt� . <br /> A) a,l7 _ Xjf�)OA>��c <br /> 1 recommend: Approval Denial El Continuance 0 Inspecto . <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> SUPERVISOR/ LEAD SENIOR Approval: Date: Z <br /> OA 11 Check Off List: Proofread Report? Correct LAND USE 4? <br /> Correct CONDYI IONS)? _ Logged in LAND USE Book'? <br /> EH 06 06 Report ft7201 November 26,201: <br />