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NOTE: PULL ALL PERMITS (SEPTIC, WELL, ETC...) MAKE COPIES FOR FILE <br /> LAND USE REPORT APP# <br /> EHD RECEIVED APP.REFERRAL: COMPLETE & SUBMIT BY <br /> DA DATE <br /> ATTN: ��� j th. ,Y��d�r , n .._. <br /> SITE ADDRESS: <br /> In completing the Land Use investigation, draw all Public Health factors on the exhibit (i.e.: sewage disposal, <br /> water supplies, etc...). WheL 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 /> t <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> Supervisor/Lead Senior Comments: <br /> 3 <br /> 1 <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> SOA IC CHECK OF LIST` J Praofr Irl report9NCorrect L',41vD USE,,#�R Y` <br /> EH 06 06 Rcy !/99 A Correct C IVDi77QN(,,4)? `, Logged rn£LAfY�IISF BOOK? <br />