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lti0-TE: PULL ALL PER'S (SEPTIC, WELL, ETC...) :KE COPIES FOR FILE <br /> , <br /> LAND USE REPORT APP# 10� f�a�— 0(— (L <br /> pp ;ues. <br /> EHD RECEIVED APP.REFERRAL: 3'g-0 --0)- COMPLETE & SUBMIT BY�Q A t. . <br /> DATE <br /> SITE ADDRESS: !� Y ' I-K CA <br /> In completing the Land Ise nvestigation, 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 /> 22 -- o3 -- -�P'a./ I _ - <br /> I recommend: Approval Denial Continuance Inspector's Signature/ <br /> 3tx*irderekeF�'eke:xxxtE�c9edrkaEokn�F*ieiriricx'.�xoFic"c"xh3cis�cxkx$r�9cis$$exe+e�e$exdexk':Fie$rx�exx�'t4tdt�r9tx3e��e�tx9t�txit4txxitirisr'.x5cit <br /> Supervisor/Lead Senior Comments: <br /> rt <br /> .� F� . <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA Lf CHECK OFF LIST Propfread reports Correct LAND USE#? <br /> EH 06 06 Rev 1/99 _ Correct CONDITIQX(S)? Lagged in L41VD'USE BOOR? <br />