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Ar <br /> NOTE: PULL ALL PERMITS (SEPTIC, WELL, ETC...) 1WrAKE COPIES FOR FILE <br /> LAND USE REPORT APP# <br /> EHD RECEIVED APP.REFERRAL: I LJ p` `d COMPLETE & SUBMIT BY <br /> DATE DATE <br /> ATTN: <br /> SITE ADDRESS: 93 <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: 1 Public sewage: <br /> SUMMARY OR COMMENTS: <br /> I recommend: Approval Denial Continuance Inspector's Signature_, _ <br /> Supervisor/Lead Senior Comments: <br /> a: 0 S Q' A ate, �ltt e.C-L <br /> SUPERVISOR/LEAD SENIOR APPROVAL: ., <br /> �OA Il GH>�'GK f)Fl�'LIST F �l'raofread reanort ; .• � Gaxrect`LAN's IISE# x,�, <br /> ' Correct CUNUITION(S)? 'Lagged�iiLAND iISE BOOIC� <br /> EH 06 06 Rev 1199 <br /> ' ��.�3�s�.;gz�.;.E.: ;€3a ¢,•-..:�¢.�.�''�,. �3�`�..4`;�ipaE� r .<$:tE��`.cce-:....�rs;rf :?��«s�,a. sd d.r e'?x�`''��:�2�¢s'�°;�c.. ate'�k:5 <br />