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1tiT4TE: PULL ALL PEP S (SEPTIC, WELL, ETC..: <br /> jKE COPIES FOR FILE <br /> LAND USE REPORT <br /> APP#_ <br /> COMPLETE & SUBMIT BY t <br /> E11D RECEIVED APP.REFERRAL' <br /> ` OA L- 0 <br /> DATE DATE <br /> ATTN: _ d'G►� <br /> SITE ADDRESS: <br /> In completing the Land Use investigation, draw all Public 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: <br /> SUMMARY OR COMMENTS: . <br /> 1 <br /> 5. a k <br /> Al <br /> 92 <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> Supervisor/Lead Senior Comments: <br /> 4 � <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> 1,`70A II CHECK OFF LIST : K ' Proofread report�� Correct,LAND-USE#7', <br /> y <br /> rx 06 06 Rev V9ga Correct fCDNDITION(S)9 x +' Logged to LAND USE B©OK7 <br /> z <br />