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NOTE: PULL ALL PE <br /> I,,.,,tITS (SEPTIC, WELL, ETC...)T-.SAKE COPIES FOR FILE <br /> 01 <br /> LAND USE REPORT AFP# Pfd- -O q -59� <br /> 'I <br /> EHD RECEIVED APP.REFERRAL COMPLETE & SUBMIT BY ] — 7 -- 0,3 <br /> HATE <br /> J� DATE <br /> ATTN: ` !f <br /> SITE ADDRESS: 5355 E <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 /> I recommend: Approval Denial Continuance Inspector's Signature <br /> 'e**o'r**�e*;Ir**Je�e9r*k�F*9c*irnk*�c***kx**s4*�r***�IraY*�E**�fr*;EvE*�F�c�k*ici;iv**ie de 9t**9reF�e�e**ie*k**9r*x***dc'ec�c***k�F*ir <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA 11 CH�GIf OFFLI `7"` .`< .Proofread report?, C`orreet LAND USE#9 <br /> EH 66 66 Rev 1/99 <br /> ,�- Logged rrr LAND OI�7 <br /> ITSE BO �. <br />