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NOTE: PULL AV,,-•ERMITS (Septic, Well, etc.) MAKl—YOPIES FOR FILE <br /> NO USE REPORT RECORD ID: SU0007158 <br /> DATE RECEIVED by EUD: April 28,2008 APPL#: PA-0700593 - - <br /> Referral Agency STAFF CONTACT: PATRICK CROSBY PE : 2622 <br /> SUBDIVISON-MINOR(MS) <br /> COMPLETE& SUBMIT BY: Tue, May 20, 2008 <br /> Assigned to : EE0005366 MED►NA <br />I. SITEADDRESS: <br /> 10149 W PELTIER RD, THORNTON APN : 01104002 05 06 <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: /9Q Public Sewer: <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: <br /> aa. o a <br /> ad.• o, <br /> I recommend: Approval Denial � Continuance ❑ I or: <br /> S nature <br /> Supervisor/Lead Senior COMMENTS: <br /> C� <br /> � G 208 <br /> '17 fA <br /> 2z •_ p _ <br /> SUPERVISOR/LEAD SENIOR Approval: p: <br /> OA/I Check Off List: ProoGend Report? _ w .._ ,,.,.. <br /> Correa CONDINON(S)? 1 <br /> 1 1106 06 Report 47201 April 29,2008 <br />