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NOTE: PULL ALL PERMITS (SEPTIC, WELL, ETC...) NrtiKE COPIES FOR FILE <br /> LAND USE <br /> REPORT APP# 02 6 <br /> } 77 <br /> COMPLETE & SUBMIT BY � <br /> EHD RECEIVED APP.REFERRAL:D 1 E DATE <br /> ATTN: <br /> SITE ADDRESS: <br /> f <br /> In completing the Land Use investigation, draw all PublicHealthfactors 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 /> ***�F*****ie*oF�t�e 'e$ric�tF*�c*9ek3ck�r�e�c�c�c*�cdcF�c*�4*ie�r�F*�eic�cdc'eicic*$e 9e�c*dcx�cic*tkxeirdsiex**ie iei�*�t�eic**F4ic**9e***draFir <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> y 3 OA II CHECK QFFLIST ` "`yee Pra'ofread repart���� ' �Corrert LAND',USL'#9��; <br /> � #;' ��"���Correcl C'DIVDITION(S)� �� egged in LAND USE BUOIf7� <br /> ' L <br /> ! [1 U6 06 Rev 1/99 <br /> I � <br />