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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0012968 <br /> DATE RECEIVED by EHD: January 14,2020 APPL#: PA-1900201 <br /> Referral Agency STAFF CONTACT GIUSEPPE SANFILIPPO PE : 2632 <br /> SITE APPROVAL-GENERAL(SA) <br /> COMPLETE&SUBMIT BY: Thu, February 13, 2020 <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: <br /> Name of Purveyor FQtW- Name of System <br /> SUMMARY OR COMMENTS: (I,V.."M cpr3SLly�Q+rC'sy� <br /> ti�0 S 1.1 L NA <br /> I recommend: Approval F-1 Denial F-1 Continuance ❑ Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> S <br /> S <br /> SUPERVISOR/LEAD SENIOR Approval: Date: vl "l.(/ <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 January 24,2020 <br />