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1 <br />/ NOTE: PULL ALL PERN''i`S (SEPTIC, WELL, ETC...) r'�.KE COPIES FOR FILE <br /> N <br /> LAND USE REPORT APP#_ZIP__QO <br /> EHD RECEIVED APP.REFERRAL; <br /> DATECOMPLETE & SUBMIT BY 1 - ? Q <br /> BATE <br /> ATTN: e� <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 /> DOUBLE BOTTOMS <br /> ,r END DUMPS y~ SEMI-BOTTOMS <br /> jp a <br /> TRANSFERS <br /> ' D. H WINN <br /> Truckin <br /> g, Inc. <br /> F Specialized A99regate <br /> o Hauling <br /> RUSSELL wwN <br /> Mobile Phone Stockton <br /> (209)483-5602 Lockeford (209) 27-55 80 <br /> /<• � � (209}727-5537 <br /> Home(203)727.5608 <br /> 1� <br /> I recommend: Approval Denial Continuance Inspector's Signature / C.•+ <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA IT CHECK Q LIST €r£ 7 Proofread report? ` orrert L,4N1?USE#T �F <br /> EH 06 06 Rev u99 "�, Go`rrect CD1I�DITI0"S E ` 'bo ed In L, NDS tISE BCJ4IC? ` <br />