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LAND USE REPORT APP# I&— VV- / <br /> £HD RECEIVED:SPP.REFERk-kL: —,)q 'GJ COMPLETE & SUBMIT BY 6/-/ y`' <br /> DATE DATE <br /> ATTN• <br /> SITE ADDRESS: A Jr—, -Q6&A <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 /> /ZF r <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> Supervisor/Lead Senior Comments: <br /> 1 <br /> A USE CHECK OFF LIST:E <br /> Did you proofread the report? <br /> SUPERVISOR/LEAD SENIOR APPROVAL: i_ Dt YQIJ USE THE CORRECT: } <br /> Land Use 4? 1 <br /> ondition(s)#? <br /> Did you log it as completed? <br />