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�— NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0010055 <br /> DATE RECEIVED by EHD: May 02,2014 APPL#: PA-1400081 <br /> Referral Agency STAFF CONTACT: RICK GRIFFIN PE : 2690 <br /> LOT LINE ADJUSTMENT(LA) <br /> COMPLETE & SUBMIT BY: ASARPVP <br /> Assigned to : EE0005944 ESCOTTO <br /> SITE ADDRESS: 20477 E LIBERTY RD, CLEMENTS APN : 00919020 22 <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 6j l� G i� ��l _ , (;�rs <br /> tai c i ` Sri <br /> L <br /> • � .mss ��G� � <br /> �Z�Gc�G OL G4e. 1 7� �55G�� c �raJL��¢.✓l�aE icc'7�.J <br /> ,&I Zk Z3i-6 `!�-&, A-6 <fMJyrZtA*k Z2) c�,r ?his <br /> I recommend: Approval 2 Denial El Continuance Inspec or• , <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> SUPERVISOR/LEAD SENIOR Approval: Date: 11,4 <br /> OA 11 Check Off List: Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report 47201 May 05.2014 <br />