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NOTE, PULL AL HERMITS (Septic, Well, etc.) MAKr''OPIES FOR FILE <br /> LAND USE REPORT RECOkV4D: SU0006920 <br /> DATE RECEIVED by EHD: January 22,2008 APPL#: PA-0700593 PRE-APP Pre-Applica <br /> Referral Agency STAFF CONTACT: PATRICK COSBY PE : 2622 <br /> j SUBDIVISON-MINOR(MS) <br /> j COMPLETE & SUBMIT BY: Wed, January 30, 2008 <br /> Assigned to : EE0005366 MEDINA <br /> n <br /> SITE ADDRESS: 10149 W PELTIER RD, THORNTON APN : 011040 02 <br /> completing the Land Use investigation, draw all Public Health factors on the exhibit (i.e., sewage disposal, water <br /> pplies, etc...). Where necessary, on an attached piece of plain paper, draw complete map of area showing population <br /> nsity, location of house, wind direction, etc.... <br /> blit Water: C.ly Public Sewer: y_y <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: <br /> I recommend: Approval ©Denial Continuance Inspe . <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> AI <br /> C i : u .t F <br /> J . <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> 'OA"II Check Off List: ProofreaJ Report? <br /> Correct CONDITION(S)? >.. • -"• `-•- <br /> EH 06 06 Repon#7201 January 22,2008 <br />