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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0008632 <br /> DATE RECEIVED by EHD: February 17,2011 APPL#: PA-1100029 <br /> Referral Agency STAFF CONTACT: JOHN FUNDERBURG PE: 2690 <br /> LOT LINE ADJUSTMENT(LA) <br /> COMPLETE &SUBMIT BY: P r <br /> n.s. . _ �—� Assigned to: EE0005944 ESCOTTO <br /> SITE ADDRESS: 16121 E LIBERTY RD, GALT APN : 00905003 04 <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: Zla 4e�­,� � <br /> ZlG <br /> • /Ud CSL Lt�C.� : 'Z�c.S C—��r�/G��. <br /> I recommend: Approval Er Denial Continuance Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> i <br /> SUPERVISOR 1 LEAD SENIOR ApprovalDate: <br /> - <br /> ..� - ,+ oxat' C}��ONO Leet[nLAI+O ?� � s <br /> B <br /> EH 06 06 Report 47201 February 17, <br />