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NOTE: PULL ALL PERMrfS (SEPTIC, WELL, ETC...) 1VrHrKE COPIES FOR FILE <br /> l <br /> LAND USE REPORT APP# D 2� v2 <br /> u � a7 <br /> EHD RECEIVED APP.REFERRAL: ! COMPLETE & SUBMIT BY -o,,& P. <br /> DATf IF "DA'IMa <br /> ATTN: r <br /> SITE ADDRESS: a g �T . & 2 k-P_ Lzan P `'Yl'- <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 zz?u /_77 /5/jl��3 /1) <br /> W� <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> de 9r i's�caYdcic�4kaF:F�E7r�<�ek�eJr�cicoFk�E�F9coFJrdr�cor3ckaF�t$c�e�elr9c�r�Fvka�e�t$r�ele��k9r�c�r�r4c�c3ck*�e�exx�exiricx�k��F9:�xie�c�r vc9t$exxieic�cx�t�t:ede <br /> i <br /> Supervisor/Lead Senior Comments: <br /> a I.KY <br /> SUPERVISORILEAD SENIOR APPROVAL: <br /> O�II CHEeK OFF LIb'� >K, j6o read report 9 r " Correcl LAND [1SE#� <br /> EH 66 06 Rev 1199 �'���� � Correct COItfDITION(S}? Lagged in l r�tv� USE BODK� <br />