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€f t + <br /> NOTE: PULL ALL PERMITS (Septic, well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0006315 <br /> DATE RECEIVED by EHD: November 07,2006 APPL#: PA-0600556 <br /> Referral Agency STAFF CONTACT: MO HATEF PE : 2690 <br /> I � LUT LINE ADJUSTMENT(LA) <br /> COMPLETE&SUBMIT BY: .. <br /> Assigned to : EE0005366 MEDINA <br /> SITE ADDRESS: 22112 N JOHNSON RD, CLEMENTS APN : 02315016 05 <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: 9 <br /> C <br /> I recommend: Approval Denial Continuance <br /> Supervisor/Lead Senior COMMENTS: Sign Pure <br /> SUPERVISOR/LEAD SENIOR Approval: Date; <br /> F =•r <br /> rit.'`� t I�raofrea'ti _�; r <br /> arreut�ONnN�Si.'ogge ASID. 36bk'j <br /> 3H 06 06 Report#7201 <br /> November 08,2006 <br />