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NOTE: PULL ALL PERMITS (SEPTIC, WELL, ETC...) IV1tiKE COPIES FOR FILE <br /> LAND USE REPORT APP# -u <br /> ncn _ V. Q <br /> O COMPLETE & SUBMIT BYE D EP1l0 <br /> EHD RECEIVED APP.REFERRAL:DAT <br /> ATTN: <br /> SITE ADDRESS: <br /> In completing the Land Use investigation, draw all Public Healt 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: //fir Public sewage: Gti� <br /> SUMMARY OR COMMENTS: <br /> 62 <br /> I recommend: Approval Denial Continuance Inspector's Signature 4., <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISORILEAD SENIOR APPROVAL: <br /> OAHCHECKOFF L/ST. _Proofread report?Correct CONDITION(S). LoSS ediorl-4NDLUSEBOORT <br /> / E1106 06 Rev 1/99 —' <br />