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- 4% -a _ _1000N.. <br /> NOTE: FULL ALL l,__,tMITS (Septic, Well, etc.) MAKE 6.—JES FOR FILE <br /> LAND USE REPORT RECORD ID: SU0008269 <br /> DATE RECEIVED by EHD: May 24,2010 APPL#: PA-1000106 <br /> Referral Agency STAFF CONTACT: RICK GRIFFIN PE : 2690 <br /> Y 2 w LOT LINE ADJUSTMENT(LA) <br /> COMPLETE &SUBMIT BY: Ab P Byff <br /> Assigned to : EE0005944 ESCOTTO <br /> SITE ADDRESS: 9595 W WALNUT GROVE RD, THORNTON APN : 00114025 26 <br /> [n 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: v _ PubIic Sewer: <br /> Name of Purveyor Name of System <br /> SUMMARY OR COMMENTS: <br /> I recommend: Approval enial Continuance Inspe r: <br /> stature <br /> Supervisor/Lead Senior COMMENTS: IL <br /> f= <br /> SUPERVISOR/LEAD SENIOR Approval: <br /> Dat <br /> O 4 Il Check Off LtSt 3 Proofresdepvrt d ; SRI', <br /> ;r- <br /> �'F <br /> at,._'-.x ErL�1�L� <br /> ------------------ <br /> EH 06 06 Report 07201 <br /> May 25,2010 <br />