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NOTE: PULL ALL PERMITS (Septic, Well, etc.) MAKE COPIES FOR FILE <br /> LAND USE REPORT RECORD ID: 500011262 <br /> DATE RECEIVED by EHD: March 06,2017 APPL th PA-0900179 <br /> Referral Agency STAFF CONTACT: STEPHANIE STOWERS PE : 2625 <br /> USE PERMIT-MINOR(UP) <br /> COMPLETE&SUBMIT BY: Fri, March 10, 2017 <br /> Assigned to : EE0005944 ESCOTTO <br /> SITE ADDRESS: 26590 N SACRAMENTO BLVD, THORNTON APN : 00122032 <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 � V4A <br /> I recommend: Approval 2Denial ❑ Continuance Inspecto . <br /> Signature <br /> Supervisor/Lead Senior COMMENTS: <br /> SUPERVISOR/ LEAD SENIOR Approval: Date: <br /> A 11 Check Off List: Proofread Report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE Book? <br /> EH 06 06 Report 47201 March 06,2017 <br />