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—� NOTE: PULL ALL44fiMITS (Septic, Well, etc.) MAKE MES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0006928 <br /> DATE RECEIVED by EHD: January 25,2008 APPL#: PA-0200247 <br /> Referral Agency STAFF CONTACT: PATRICK CROSBY PE : 2656 <br /> REVISIONS TO ACTIONS (RA) <br /> COMPLETE& SUBMIT BY: Tue, February 19, 2008 Assigned to : EE0005366 MEDINA <br /> SITE ADDRESS: 26485 N THORNTON RD,THORNTON APN : 00114040 <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 /> commend: Approve— Denial El Continuance I e r: <br /> Sign utu re <br /> rvisor/Lead Senior COMMENTS: <br /> PEIlk ISOR/ LEAD SENIOR Approval: Darr. <br /> 11 Check Off List: Proo$ead Report?__ Correc[LAND USE i`.? _ <br /> Correct CONDITJON(S)? '" Logged in LAND CISH Book" <br /> 06 06 Report#7201 January 29,2008 <br />