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NOTE: PULL ALL PERNk._,-ZS (SEPTIC, W ,LL, ETC...} ,,, EKE COPIES FOR FILE <br /> T.-rn e <br /> LAND USE REPORT APP# ,4 — g ( � �x fyn <br /> MID RECEIVED APP.REFERRAL: I COMPLETE & SUBMIT BY I - <br /> DATE DATE <br /> ATTN: J L <br /> SITE ADDRESS: f b o <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 /> ,, ,. <br /> Zle"?V- s L-12 <br /> I recommend: Approval Denial Continuance Inspector's Signature � - <br /> Supervisor/Lead Senior Comments: <br /> .FH A <br /> SUPERVISORILEAD SENIOR APPROVAL: <br /> 1D II CHECK OFA'DPropfread report�,- ...- Correct LAND UdSE <br /> • Correct <br /> EH 06 06 Rev 1149 �� ' u r�"IO1V{S� <br /> GOND �. LClggel1111 Lf11VD USE BOOlf7 <br /> .. <br />