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NOTE: PULL ALL PERMI S (SEPTIC, WELL, ETC...) M -i--,E COPIES FOR FILE <br /> LAND USE REPORT APP# <br /> APP.REFERRAL: COMPLETE & SUBMIT BY <br /> EI3D RECEIVED <br /> DATE 2A II DATE <br /> ATTN: 30,S-t. eubi loll <br /> SITE ADDRESS: t/S t' rr� <br /> in completing the Land Use investigation, draw all Public <br /> Health factors on the exhibit (i.e.: sewage disposal, <br /> water supplies, etc...). Where necessary, on an attached piece of plain paper, draw completed map of area <br /> showing population density, location of house, wind direction, etc.... <br /> Public water: Public sewage: 0 - <br /> I <br /> SUMMARY OR COMMENTS: <br /> f V ov, <br /> I recommend: Approval Denial Continuance Inspector's Signatur <br /> f <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> f6ASIICHEF OJFF�LIS Pioofre t report? Correct LA1Vb USE#?' <br /> EH 06 ob Rev v99 � E� �arrt CilIVUTTiaN(S��F, LaggedinL41VZ1 LASE BOOR <br /> i <br />