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NOTE: PULL ALL7_ _RMITS (Septic, Well, etc.) MAKE`S-JPIES FOR FILE' <br /> LAND USE REPORT RECORD ID: SU0005906 <br /> DATE RECEIVED by EHD: February 07,2006 APPL#: PA-0600050 <br /> Referral Agency STAFF CONTACT: MO HATEF PE ; 2690 <br /> LOT LINE ADJUSTMENT(LA) <br /> COMPLETE&SUBMIT BY: A ^ AM MIA� <br /> Assigned to : EE0005366 MEDINA <br /> SITE ADDRESS: 17601 E FRAZIE ` - �, DE r APN : 06511004 05 <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 /> I <br /> I recommend: Approval Denial Continuance ❑ Inspector: <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: ' <br /> t <br /> I <br /> i <br /> I <br /> I <br /> 1 <br /> SUPERVISOR/LEAD SENIOR Approval: Date: 2 <br /> �.0 O1Stt' O m � ss <br /> - <br /> �a�Ct <br /> i <br /> EH 06 06 Report 47201 February 07,2006 <br />