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�t 1�TOTV,: PULL ALL PERM_,,S (SEPTIC, WELL, ETC...) I KE COPIES FOR FILE <br /> LAND USE REPORT APP# L/-�- -0 t - Z <br /> Clio r-e- <br /> EIID RECEIVED APP.REFERRAL: -0( COMPLETE & SUBMIT BY P rro- -4 <br /> DATE / DATE <br /> ATTN: U 6 e- <br /> SITE ADDRESS: 1 --20(-) S E .Sl- 95? 4W L,,, <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 /> -6 <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISORILEAD SENIOR APPROVAL: <br /> XfaA IT CHECIfC DFF LIST ` :Proofread reports ' Correct LANVD USE#T <br /> FH 06 06 Rev 1199 Correct CONDIT70N(S). Legged rn LAND USE BOOK?,, <br /> ��. �. �: <br />