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NOTE: 'PULL ALL PER S (SEPTIC, WELL, ETC...) 11'I_KE COPIES FOR FILE <br /> Prt <br /> LAND USE REPORT APP#��--oy - adz 5 LSON) <br /> EHD RECEIVED APP.REFERRAL: v COMPLETE & SUBMIT BY 2 p-o_3-.......__ <br /> 5ATIt 06ATE <br /> ATTN: i GI <br /> SITE ADDRESS: a-7 L 51z. 0 <br /> In completing the Land Use investigation, draw all Public Health factors on the exh' it(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: AIV Public sewage: Aw <br /> SUMMARY OR COMMENTS: 1' <br /> aww XIV/� <br /> llvd"�� "v - <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> 4c 9ry'c�c�ra4vcEa'cdcaE:FiedckaFdc:EEknFkvEic:EEdc:Fvc$c�vcdckicieir9rxhxxkx3�9c�r�cJrxicic$cxxEackFkaFicdcicEkFlra�c:F$et'r3c�'r�r*ic�rx�cxoFa'cie�e'ede'ekde <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> QA'l OFF LIST F Praa)rread re orta3: " Correct£:SND USES 3 <br /> CONDITION{ <br /> I r1 06 06 Rev 1199Correct J � ' Loged <br /> -d <br />