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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0012549 <br /> DATE RECEIVED by EHD: September 13,2019 APPL#: PA-1900201 <br /> Referral Agency STAFF CONTACT GIUSEPPE SANFILIPPO PE : 2632 <br /> SITE APPROVAL-GENERAL(SA) <br /> COMPLETE&SUBMIT BY: Thu, October 10, 2019 <br /> Assigned to : EE0000418 KITH <br /> SITE ADDRESS: 22370 N BEZLEY RD, CLEMENTS APN : 01926054 <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: lyo t <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: 0,174 S r #0 $-ep A°L f--ty-"-`t3 <br /> Xle . <br /> ,54,e S Ye Vae., ,Ve) wr(a dr s:�PAC W/Kly ,e-2s .1v(e-04. <br /> ,iyrv�+rCv/�A <br /> 1 /,e <br /> I recommend: Approval F1 Denial Continuance ❑ Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> SUPERVISOR/LEAD SENIOR Approval: Date: <br /> A II h k Off List: Proofread Report? Correct LAND USE#? <br /> Correct CONDITIONS)? Logged in LAND USE Book? <br /> EH 06 06 Report#7201 September 13,2019 <br />