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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0010814 <br /> DATE RECEIVED by EHD: March 14,2016 APPL#: PA-1600038 <br /> Referral Agency STAFF CONTACT: RICK GRIFFIN PE : 2690 <br /> CONA�n ILL LOT LINE ADJUSTMENT(LA) <br /> N7�W ROYV: Fri March 18 2016 <br /> VVVVVV����((������1 ��L��L////// � ' ' Assigned to : EE0005944 ESCOTTO <br /> SITE ADDRESS: 20988 E HWY 12 , CLEMENTS APN : 02303009 <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 /> /7''iL�F7 / �✓ZAi dS+ �lJ 6-1 72E6.vb'eC, 42jct,�e,4 zrs-4 .Sc";DZte a'I:.57,cm .4 1-1-710i <br /> • /�'t�.e_y�Z ,s -#� �tes/s7b�t��ve��uil�l�. <br /> 3 'gg2ai� <br /> A�Jr� ��Jvszs � f�k5—iu�Gbtt,• <br /> ' ,cb l� oL L�,Q. /f�fS7�/cS'SGLE3 cF�rz�t.✓L�-cam .[$ct�J <br /> d:P'/ cis l n 4rsc 4a/ <br /> I recommend: Approval12 Denial ❑ Continuance ❑ Inspector: , <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> SUPERVISOR/ LEAD SENIOR Approval: ` Date: <br /> OA 11 Check Off List: Proofread Reporr? Correct LAND IISE#? ' <br /> Correct CONDITION(S)? Logsed in LAND USE Book? <br /> EH 11111 Report 17101 March 14.2010 <br />