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NOTE: PULL ALL PE)tMITS (Septic, Well, etc.) MAKE CO S FOR FILE <br /> LAND USE REPORT RECORD ID: SU0004870 <br /> DATE RECEIVED by EHD: March 01,2005 APPL#: PA-05-97 <br /> Referral Agency STAFF CONTACT: RICK GRIFFIN PE : 2622 <br /> SUBDIVISON-MINOR(MS) <br /> COMPLETE&SUBMIT BY: Tue, March 22, 2005 <br /> Assigned to : EE0005944 ESCOTTO <br /> SITE ADDRESS: 22410 E MILTON RD, LINDEN APN : 09304007 <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 /> -t cE '�«3c1 .r/D/�'►tfZ3'zh/F-cc.E <br /> - Qhs<aEst.'Sr° ztcn7 <br /> iczu�k:�rl a/7�5E7�ZG»2z«,: ii � fie. . ls•;�1s.+:l,T,I3rFc1f �,�. <br /> • 7i1E d�srr�.4��,.r��I �+r/���r/l�c�%Y/sa�r.�su�t>7..r,�.Es�ce�:3¢ <br /> I recommend: Approval benial Continuance Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> B o aKeO <br /> C. <br /> (L!l 0 9 <br /> 42 <br /> F 11 = 030.. <br /> SUPERVISOR/LEAD SENIOR Approval: / Date: d'3 0- v`r <br /> OA I/Check Off List Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 Page I I March 02,2005 <br />