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NOTE: PULL ALL P—rRMITS (Septic, Well, etc.) MAKE Gu`PIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0006534 <br /> DATE RECEIVED by EHD: April 24,2007 APPL#: PA-0500563 <br /> Referral Agency STAFF CONTACT: JASON JONES PE : 2631 <br /> SITE APPROVAL-MINOR(SA) <br /> COMPLETE& SUBMIT BY: Tue, May B, 2307 Assigned to : EE0005366 MEDINA <br /> SITE ADDRESS: 7675 E LIBERTY RD, GALT APN : 00702007 <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 populatio <br /> density, location of house, wind direction, etc.... <br /> Public Water: Public Sewer: <br /> Name <br /> //of Purveyor Name of System <br /> SUMMARY OR COMMENTS: <br /> aa.• oa- � <br /> zoo <br /> 1 recommend: Approval Denial F] Continuance Ins <br /> E-1 ector <br /> 5' nate e <br /> rvisor/Lead Senior COMMENTS: <br /> D7. P , n �_ <br /> � <br /> WPERVISOR/LEAD SENIOR Approval: _ Date: / <br /> :II Check Off List: Proofread Report? — - Correct LAND USE#9 <br /> Corre(t C0NDl1l0N(S)? Lpgged in LAND USB 13ook? - <br /> ?B 06 06 Report#7201 April 24,2007 <br />