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NOTE: PULL ALL PE IT <br /> J S (SEPTIC, WELL, ETC...) 1V;� E COPIES FOR FILE <br /> A - _ , L H) <br /> APP# 3 <br /> LAND USE REPORT S �� +> <br /> EHD RECEIVED APP.REFERRAL: D( 1 ` 03 COMPLETE & SUBMIT BY DATE <br /> BAT <br /> ATTN: eff 9-6 <br /> SITE ADDRESS: 9 /2 <br /> In completing the Land Use investigation, draw all Public Health factorsonthe 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: <br /> SUMMARY OR COMMENTS:/ <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> **de************�'c�Fx****c�r*�r*$c'ede*dc$rfreic*lcxic*ieicisacdc7cicic*ibex***ie****x�e�r*k�e***�e*deicvk�Fycicir*4c�e�e***7kx** <br /> SupervisorlLead Senior Comments: <br /> SUPERVISOR/LEAD SENIOR APPROVAL: " <br /> FI HECJC OFF LIST- <br /> Axe"�roafread report? Correct"LAND <br /> 3 Correct,CONDITION(S)?# < 'Lagged rn LAND USEBODIC?� ' <br /> 171106 06 Rev 1199 <br />