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NOTE: PULL ALL�-RMITS (Septic, Well, etc.) MAKEy4P1ES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0005907 <br /> DATE RECEIVED by EHD: February 07,2006 APPL#: PA-0600044 <br /> Referral Agency STAFF CONTACT: KEVIN SWANSON PE : 2622 <br /> SUBDIVISON-MINOR(MS) <br /> COMPLETE & SUBMIT BY: Tue, March 7, 2006 <br /> Assigned to : E130005366 MEDINA <br /> SITE ADDRESS: 11964 E LIBERTY RD, GALT APN : 00713010 <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: 1G,-m- Public Sewer: �y�{ <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: '575 ,rte <br /> /J&/- <br /> .a ///-s e-r' ni ih , .moi-,chi, <br /> 'r Via : —sF% <br /> Ca 202:01 Applicant shall uncover existing septic tank and expose existing leach lines to <br /> verify that leach lines do not cross over Proposed Parcel #I and Designated Remainder <br /> property lines. This shall be completed under a consultation permit and inspection <br /> i with the Environmental Health Department. The fee for the consultation permit is <br /> $186.00 <br /> I recommend: Approval ErDenial ❑ Continuance In 'r 1 j <br /> Si nature <br /> Supervisor/Lead Senior COMMENTS: <br /> d <br /> A <br /> � Ca <br /> D <br /> 22 O -41 �/ 2 <br /> C Z Mz 0 / \ <br /> C zoo 0 2 <br /> VISOR/LEAD SENIOR Approval. Date: <br /> �t#7201 February 07,2006 <br />