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lei <br /> NOTE: PULL ALL PERM fS" (SEPTIC, WELL, ETC...) M.—KE COPIES FOR FILE <br /> LAND USE <br /> REPORT APP#_� C� - � <br /> EHD RECEIVED APP_REFERRAL: 0 3 COMPLETE & SUBMIT BY <br /> DAT DATE <br /> D34W <br /> AT N• J <br /> SITE ADDRESS: A , dD�^ <br /> In completing the Land Use investigation, draw all Pub is 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 /> 5. <br /> -e3 <br /> eS <br /> I recommend: Approval Denial Continuance Inspector's Signatur <br /> iso'e*�cF**9e�e*ie**x*9c*ar�eJrc*�F*�c�c*�Fic**7sxie*�t***aF*�rds*>cvF�c*�c�ex***�k*�c*ixF�eic*X***�t9:x***+'edc*aE*+e do**�r�e�c*vF�ea'eie <br /> Supervisor/Lead Senior Comments: <br /> o'►�— <br /> S <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA 1l CHECK OFF LIST' proofread report?' Correct LAND USE#9 . <br /> x , Lv ed an LANI3 USE BOOKS <br /> Correct CONDITIONS) gg x <br /> Lai db 06 Rev 1199 <br /> w� gib, h�K nE <br />