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NOTE: PULL ALL (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0005707 <br /> P DATE RECEIVED by EHD: October 18,2005 APPL##: PA-0500489 <br /> Referral Agency STAFF CONTACT: J DrMG PE : 2690 <br /> LOT LINE ADJUSTMENT(LA) <br /> j COMPLETE&SUBMIT B o �t <br /> Assigned to : EE0005366 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 /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS:�O <br /> f <br /> ;I recommend: Approv Denial Continuance spect <br /> ignature <br /> Supervisor/Lead Senior COMMENTS: <br /> �[4 .0 /JAS N <br /> e s dA05el .� <br /> SUPERVISOR 1 LEAD SENIOR Approval: Date: <br /> 'OA'11 Check 0#b'st: --_ Proofread Report? Coriect.LAND USE.#? <br /> s .Correct CONDITION(S)? Logged in I'A D USE Book? <br /> EH 06 06 Report 47201 October 19,2005 <br />