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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0009847 <br /> DATE RECEIVED by EHD: December 12,2013 APPL#: PA-1300213 <br /> Referral Agency STAFF CONTACT: JOHN L FUNDERBURG PE: 2690 <br /> ASA P. <br /> i LOT LINE ADJUSTMENT(LA) <br /> COMPLETE &SUBMIT BY: <br /> Assigned to : EE0005944 ESCOTTO <br /> SITE ADDRESS: 6125 E QUASHNICK RD, STOCK bN APN: 08653002 <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: /2 �6 <br /> yI- - ort <br /> v <br /> 1 recommend: Approval ® Denial Continuance ❑ Inspecto <br /> re <br /> Sunervisor/Lead Senior COMMENTS: <br /> DI. Cr-t7 l Q� vim, /cmr� a CYvvr�at�L <br /> SLPERV ISOR . LI:%D SENIOR ApproNal: ILr -i-v*YL't— _ Date: / Z r 3 <br /> A 11 Check Off I ist: Proofread Report? Coast LAND USE#? <br /> Correct CONDITION(S)? kya cd in LAND USE Book? <br />