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�07 - <br /> NOTE: PULL ALL-_ RMITS (Septic, Well, etc.) MAKE PIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0005985 <br /> DATE RECEIVED by EHD: April 03,2006 APPL#: PA-0600175 <br /> Referral Agency STAFF CONTACT: KEVIN SWANSON PE: 2690 <br /> 9 LOT LINE ADJUSTMENT(LA) <br /> COMPLETE& SUBMIT BY: A, rN n 0141, <br /> Assigned to : EE0005366 MEDINA <br /> P' SITE ADDRESS: 16276 N LINN , I APN : 05314002 04 <br /> 0 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 /> :eek <br /> "— /7'7r <br /> �i c � Qom/ ✓ <br /> I recommend: Approval Denial Continuance In Mor: <br /> Supervisor/Lead Senior COMMENTS: Sign ture <br /> nf4 <br /> SUPERVISOR/LEAD SENIOR Approval Date: • (, <br /> Chick Off L1st o €re Re'ort 5 <br /> o`ect'L <br /> LoggflLl�NI]USE,Bgotc2 <br /> 6H 06 06 Report#7201 April 04,7' <br />