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CNOTE: PULL AL6jRMITS (Septic, Well, etc.) MAKE„JPIES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0005800 <br /> DATE RECEIVED by EHD: December 06,2005 APPL#: PA-0500800 <br /> Referral Agency STAFF CONTACT: CEALY LEIN PE : 2631 <br /> SITE APPROVAL-MINOR(SA) <br /> COMPLETE&SUBMIT BY: Tue, December 20P2005 <br /> Assigned to : EE0005366 MEDINA <br /> SITE ADDRESS: WALNUT GROVE RD,THORNTON APN : 00114049 <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: n� Public Sewer: �� <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: <br /> oil jrviA <br /> I recommend: Approval Denial Continuance In ecto T 11 <br /> ignature <br /> Supervisor/Lead Senior COMMENTS: <br /> P /w O .1GY /dnf <br /> SUPERVISOR/ LEAD SENIOR Approval: Date: <br /> OA 11 Check Off List: Proofread Report? Correct LAND USE 9? <br /> Correct CONDITION(S)? Logged is LAND USE [look? <br /> EH 06 06 Report#7201 December 07,2005 <br />