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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE'GOPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0004961 <br /> DATE RECEIVED by EHD: March 29,2005 APPL#: PA-05-162 <br /> Referral Agency STAFF CONTACT: GILLIAN HAYES PE : 2625 <br /> USE PERMIT-MINOR(UP) <br /> COMPLETE& SUBMIT BY: Wed, April 13, 2005 <br /> Assigned to : EE0000149 BORGES <br /> SITE ADDRESS: 13392 E LOCKEFORD RANCH DR, LOCKEFORD APN : 05131041 <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: //7�/ <br /> /�J <br /> I recommend: Approval Denial Continuance Ins ector• <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> 6 <br /> A- c _0 7 <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> OA 11 Check OS List• Proofread Report? Correct LAND USE#? <br /> Correct CONDMON(S)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 Page 4 March 30,2005 <br />