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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0012572 <br /> DATE RECEIVED by EHD: September 24,2019 APPL#: PA-1900213 <br /> Referral Agency STAFF CONTACT RICK GRIFFIN PE : 2690 <br /> LOT LINE ADJUSTMENT(LA) <br /> COMPLETE&SUBMIT BY: Fri, September 27, 2079 <br /> Assigned to : EE0000418 KITH <br /> SITE ADDRESS: 16580 E HWY 88 ,LOCKEFORD APN: 01918012,01918034 <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: Al,,,, Public Sewer: <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: n^ <br /> 07"� ,01 Irt✓,Cw.' Ar^n/ dlq- ltDJ2 4ad dcrsali{lsitf; /6Sg'O G ��ib l'Dff <br /> 6• //tea- >-r NC) <br /> 5 OR em <br /> ®nQ S�i�/i � �� sy6 t�.�.- i�'��� �� �K �/+c lfii- /(os�f�E•��� �S"�' 1���-� l s�cr��o3�/�3), <br /> S/� y 1,'t y_2�,r y� 6 h[+r�.r�- �L�6c W.�!•- J�l��"� s�ld+�C'rw � Ada Co•ticyw 6� ,�s,�.0 n,�l�( <br /> I recommend: Approval ❑ Denial ❑ Continuance Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> A II heck Off List: Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 September 26,2019 <br />