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NOTE: PULL ALL'i,. RMITS (Septic, Well, etc.) MAKE'. SPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0006068 <br /> DATE RECEIVED by EHD: May 30,2006 APPL#: PA-0600300 <br /> Referral Agency STAFF CONTACT: KATHY ALLEN PE ; 2690 <br /> LOT LINE ADJUSTMENT(LA) <br /> COMPLETE&SUBMIT BY: A A r) Assigned to : EE0004045 TASIOPOULOS <br /> SITE ADDRESS: 17590 S KELSO ,' APN: 20903003 <br /> Qd <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: 4— <br /> Approval Denial Continuance Inspector• <br /> I recommend: App ❑ <br /> � ature <br /> El <br /> Suaervisor/Lead� Senior COMMENTS:�/C.P�I/c 47o-k-. GVc c•ti U7L •� Z n T"7�1! t1LG (�[ �t r�� w r�l ✓� �Lt✓'�- <br /> 5 te�[G �yvsrGlR� �'I� <br /> � v <br /> t <br /> o tin <br /> SUPERVISOR 1 LEAD SENIOR Approval Date <br /> y - �7�v�"3u w- xaa x a• � 3u-5�@�L�aw. :t _. #,v �, - � +&fir ¢�,� '� �°- '" <br /> OA1 G eckxfl ,CFs a Prfr�adly;�eY,portl , r�c IsANS #: ; <br /> EH 06 06 Report#7201 May 31,2046 <br />