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�l <br /> I� NOTE: PULL ALL PEKE S (SEPTIC, WELL, ETC...} KE COPIES FOR <br /> FILE <br /> LAND USE REPORT APP# L� <br /> EHD RECEIVED APP.REFERRAL: OC ,Z COMPLETE & SUBMIT BY A A 0 <br /> DAT _ <br /> ATTN: <br /> SITE ADDRESS: <br /> In completing the Land Use investigation, draw all Public Health factors on the exhibit (i.e.: sewage disposal, <br /> water supplIII <br /> ies, 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: <br /> SUMMARY OR COMMENTS: <br /> 6L ' . <br /> I recommend: Approval l Denial Continuance Inspector's Signatu <br /> *+s9r***Jcx�'c**ic*K9c**�IraF*�E**fie*�c�c**ie iek9ttEdr*�Fx9c$c***Jc�r9r**k�Fx�r:E*irvc�t9s**�k**icoc*�s�exdt*;Ic** reF�c :irx'e�e�F***ire <br /> Supervisor/Lead Senior Comments: <br /> Q <br /> SUPERVISORILEAD SENIOR APPROVVALA: &���� <br /> OA II GI.�'ECK OFF LIST ��`�° Prpofread report? 'Correct I.�1ND USE#9 <br /> EH 06 06 Rev 1199 ' "CIJITect C0IVDITION S ° Lo -� <br />