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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0009630 <br /> DATE RECEIVED by EHD: May 07,2013 APPL#: PA-1300064 <br /> Referral Agency STAFF CONTACT: STEPHANIE STOWERS PE : 2690 <br /> LOT LINE ADJUSTMENT(LA) <br /> COMPLETE& SUBMIT BY: A R A R Ry. <br /> —0 1 % Assigned to: EE0005944 ESCOTTO <br /> SITE ADDRESS: 28233 N NICHOLS RD, GALT APN : 00508030 32 38 39 <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: <br /> /�32�� i c�lz�z�s itsiao�lc� wrzrr�t ��z� st-sz 4 / .,!=w <br /> 4-.rs,1��ar� � B��✓ Tyc�Tc�2rzy c�=z�1�Ic��.�s .9� c�a.✓it <br /> 1l��im4'ka.�Z�: <br /> [ recommend: Approval Denial Continuance F Inspect <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> SUPERVISOR/LEAD SENIOR Approval: Date. <br /> OA II Check Off list: Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> 811 06 06 Repon 117201 MaN 07.201: <br />