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1 RB K <br /> 1�J.J <br /> 1 Ct <br /> NOTE: ]PULL ALL PERM-rfS (SEPTIC, WELL, ETC...) MAKE COPIES FOR FILE <br /> LAND USE REPORT APP#: PA-04-123 (VR) <br /> EHD RECEIVED APP.REFERRAL: 3/23/04 COMPLETE & SUBMIT BY: 03/30/04 <br /> DATE DATE <br /> ATTN: JOHN FUNDERBURY <br /> SITE ADDRESS: 14721 EAST COPPEROPLIS ROAD STOCKTON <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 a completed map of area <br /> showing population density, location of house, wind direction, etc.... <br /> Public water: Public sewage: <br /> SUMMAIF.Y OR COMMENTS: <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> Supervisor/Le aq Senior Comments: <br /> F C"L'70 . <br /> Am <br /> SUPERVI[SORILEAD SENIOR APPROVAL: <br /> EH 06 06 Rev 1199 <br />