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NOTE: PULL AL HERMITS (Septic, Well, etc.) MAK COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0007633 <br /> DATE RECEIVED by ERD: March 13,2009 APPL#: PA-0800323 <br /> Referral Agency STAFF CONTACT: KEVIN SWANSON PE : 2622 <br /> SUBDIVISON-MINOR(MS) <br /> COMPLETE& SUBMIT BY: Tue, April 7, 2009 <br /> Assigned to : EE0005366 MEDINA <br /> SITE ADDRESS: 10020 W PELTIER RD, THORNTON APN: 0110600107 08 <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: 1.1 Y Public Sewer: /tY1Q <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: �a�� —! `�� <br /> aa. -oma <br /> I recommend: Approval Denial 1:1 Continuance ❑ Inspec <br /> $gnatu" <br /> Supervisor/Lead Senior COMMENTS: <br /> F�f <br /> A <br /> IV <br /> CCl 2? D2 ikA.�L �n C L <br /> SUPERVISOR/ LEAD SENIOR Approval: /- Date: <br /> OA If Check OH List: Proofread Report? o <br /> "I Correct CONDITIONS)? Logged in LAND USE Book? - <br /> EH 06 06 Report#7201 March 16,2009 <br />