Laserfiche WebLink
NOTE: PULL AL,,cRMITS (Septic, Well, etc.) MAKL`,PPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0005088 <br /> DATE RECEIVED by EHD: June 15,2005 APPL#: PA-659)0153 <br /> Referral Agency STAFF CONTACT: KARLA KUHL PE : 2690 <br /> LOT LINE ADJUSTMENT(LA) <br /> COMPLETE&SUBMIT BY: ; <br /> y — M1 Assigned to: EE0005366 MEDINA <br /> SITE ADDRESS: 10101 W WALNUT GROVE RD, THORNTON APN : 00114002 <br /> [n 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 /> I�ty of Purveyor JJ Name of System <br /> SUMMARY OR COMMENTS: //6-0� /� p�,�/ � � <br /> ,Of�.�/: i�cdf � '�f4✓.�Gl..Gc�ca1 S� liirYo lcYf�✓.!i�n. <br /> q�lriry p� 4,raGr6- /�j Ofr'o� >i�jni�irnri ���ra iz�rh�r. cJ 4.P// <br /> aa. d a <br /> aa. . <br /> [ recommend: Approval Denial ❑ Continuance Inspec tea. <br /> Sig re <br /> Supervisor/Lead Senior COMMENTS: <br /> o l <br /> SLPERVISOR/ LLAD SENIOR Approval: �'� Date: <br /> OA 11 Check Off List: Proofread Report? Correct LAND USG#? - <br /> Correct C0ND1T10N(S)? LoL&cd in LAND USE Book? <br /> EH 06 06 Report#7201 June 15,2005 <br />