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fd <br /> NOTE, : .p`PE; PULL ALL PERM1�S (SEPTIC, WELL, ETC. ) Mli�KE COPIES FOR FILE <br /> { <br /> LANA USE REPORT APP# <br /> 11 <br /> ESID RECEIVED APP.REFERRAL: !�- COMPLETE & SUBMIT 13 <br /> DATE N <br /> ATTN: <br /> SITE ADDRESS: tLO <br /> In completing the Land Use investigation, draw L11Public 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 /> W�e <br /> d <br /> cR <br /> 4 � <br /> I recommend: Approval Denial Continuance Inspector's Signatur <br /> 3 <br /> Supervisor/Lead Senior Comments: <br /> 5 <br /> T <br /> y .SuPERVISORILEAD SENIOR APPROVAL: <br /> '`OA II CHECH OFF,T�iST E' Proafreud report? � sorrect LAND USE#7� }, <br /> r11 l Lo ed inf1lND USE BOOX7 ' <br /> CarredQIVDIII+DN{S} <br /> )6 06 Rev 1/99 n7 a ` ` .EaaK" b. �s€Ez°�' 't` ,.;€f`fE(,b.a„JtE°s�,e.vur�a n t•ti,°ra a�4:.-.'hr 'rda:d,:'^zr§3 tt,�3:,P#ti^ .< .e:.3;>t b iq�,y <br /> i. .a <br />