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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0010727 <br /> DATE RECEIVED by EHD: December 24,2015 APPL#: PA-1500258 <br /> Referral Agency STAFF CONTACT: RICK GRIFFIN PE : 2690 <br /> CoMMLnn nn\�,� LOT LINE ADJUSTMENT(LA) <br /> ZI' : Thu, December 31, 2015 <br /> 11 VVVV VIII � Assigned to : EE0004045 TAS[OPOOLOS <br /> SITE ADDRESS: 28651 E SHELTON RD,LINDEN APN : 09334015 <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 Qpyor Name of System <br /> SUMMARY OR COMMENTS: ! � /, ' �- Yux �l�h• �lL�L !M C-Z <br /> ivi L✓ <br /> L-e�a 4i-7 enj& 94f� <br /> �� vu"t rJutyL <br /> Ldz 6,1 <br /> •5 /Iron -t <br /> v <br /> I recommend: Approval ® Denial Continuance Inspecto <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> � J <br /> SUPERVISOR/LEAD SENIOR Approval: -_— Date: <br /> L <br /> OA 11 Check Off Li <br /> Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EI-106 06 Report 97201 December 24,2015 <br />