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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0010649 <br /> DATE RECEIVED by EHD: October O6,2015 APPL#: PA-1500185 <br /> Referral Agency STAFF CONTACT: CORINNE KING PE : 2690 <br /> �y <br /> ^` , g LOT LINE ADJUSTMENT(LA) <br /> COMPLETE&SUBMIT BY: P 4AU�l-�lH/a <br /> � n Assigned to: EE0005944 ESCOTTO <br /> SITE ADDRESS: 26620 N NOWELL RD,THORNTON APN: 00123003 05 10 20 <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: iCLLf TlE�%BJ: D.r/� J/�I7J <br /> hki &!'� / �.1s s1 /sYLc�//?�n%u�4 Czcylucs44'.efc a iu 4JlXf/ylua7� %��Z<� <br /> SY -9 <br /> si/ Jan a-,W Ile Zoo- <br /> Cdl co��s7i.,,� t� uts�d�zc/�GficoJ <br /> • � l�C. �l�Q l�scie-� Li�Cctl��1/c(3��7� <br /> -nom <br /> .4 cd 1-"A-9d-- <br /> I <br /> -" -I recommend: Approval [a Denial ❑ Continuance ❑ Inspect <br /> Signature <br /> Supervisor/Lead Senior COMME]VTS: <br /> ) <br /> SUPERVISOR/ LEAD SENIOR Approval: Date: <br /> OA 11 Che kff List Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE nook? <br /> EH 06 06 Report#7201 October 06,2015 <br />