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a k <br /> i <br /> NOTE: PULL ArLE ,.ERMITS (Septic, Well, etc.) MAKE r:JP1ES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0008439 <br /> DATE RECEIVED by EHD: September 08,2010 APPL##: PA-1000207 <br /> Referral Agency STAFF CONTACT: JOHN FUNDERBURG PE: 2622 <br /> SUBDIVISON-MINOR(MS) <br /> COMPLETE&SUBMIT BY: Wed, September 29, 2010 <br /> Assigned to: EE0005944 ESCOTTO <br /> SITE ADDRESS: 18301 N JACK TONE RD, LOCKEFORD APN : '}499}x_ <br /> [n 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 /> x <br /> S` <br /> 13r.4� 4 l � <br /> . 6;Z- <br /> I recommend. Approval Denial Continuance Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS <br /> zct� 10. <br /> SUPERVISOR/LEAD SENIOR Approval <br /> � � Date <br /> fli4!1 Check(3fi Lt"Sfr' f'coia Iiep grC +y � RM f <br /> < y`� - ,sa .,. ;�.igk �.�` ¢g ez4a¢ sc��,�€ °.x. ^; --�--Sr v � s�ts •;r °�. <br /> EH 06 06 Report 97201 <br /> September 08,2010 <br />