Laserfiche WebLink
NOTE: PULL ALL t, MITS (Septic, Well, etc.) MAKE MES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0006664 <br /> DATE RECEIVED by EHD: July 31,2007 APPL#: PA-0700354 <br /> Referral Agency STAFF CONTACT: JOHN FUNDERBURG PE : 2690 <br /> LOT LINE ADJUSTMENT(LA) <br /> COMPLETE& SUBMIT BY: AS A RE' <br /> Assigned to : EE0005366 MEDINA <br /> SITE ADDRESS: 21563 E HWY 12 , CLEMENTS APN : 02311026 <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 recommend: Approval Denial Continuance Inspector: --- <br /> Si nature ` <br /> Supervisor/Lead Senior COMMENTS <br /> SUPERVISOR/LEAD SENIOR Approval Date <br /> dOA lr eolW ?USE#? rW <br /> orre8 <br /> CC3NUITI(3NSj`1a c ' 7 rggein�AiJ <br /> EH 06 06 Report 47201 July 31,2007 <br />