Laserfiche WebLink
Gh_ <br /> !` NOTE: PULL ALL i�=RMITS (Septic,Well, etc.) MAKE L._.+°IES FOR FILE <br /> '',BLAND USE REPORT RECORD ID: SU0005287 <br /> DATE RECEIVED by EHD: August 10,2005 APPL#: PA-0500489 <br /> J Referral Agency STAFF CONTACT: GILLIAN HAYES PE : 2690 <br /> LOT LINE ADJUSTMENT(LA) <br /> COMPLETE&SUBMIT BY: ASAP=BY' p2o� a5 <br /> Assigned to : E130005366 MEDINA <br /> SITE ADDRESS: 8720 W PINE ST,THORNTON APN : 00120013& 14 <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 /> N e of Purveyor Name of System <br /> (SUMMARY OR COMMENTS.� <br /> I recommend: Approval finial ContinuanceEl <br /> Ins actor: �� <br /> (Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> k" <br /> I� <br /> `r <br /> Ff <br /> i <br /> I� <br /> I� <br /> I� <br /> 'h <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> A 11 Gheck Off List: "'Dread.Report?: Correct 4&ND USE#7 � <br /> Correct CQNDITTON(S)T Logged in LAND USE Book?; <br /> �h <br /> �EH 06 06 Report#7201 August 11,2005 <br /> i� <br />