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NOTE: PULL ALL PE 'S (SEPTIC, WELL, ETC.- KE COPIES FOR FILE <br /> SPORT AP " <br /> LAND USE R� � � ag 0� <br /> MID RECEIVED APP.REFERRAL: COMPLETE & SUBMIT BY , <br /> D TE DATE <br /> ATTN: <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...). 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 /> I recommend: Approval Denial Continuance Inspector's Signature <br /> Supervisor/Lead Senior Comment <br /> O <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> O �I CHECICOFI�LIST t Proofread report? Correct LAND i'ISE#tq` ' <br /> Correct CONDITIONS}9 � Lagged in LAND USE BOOK?; <br /> Eli 06 06 Rev 1199 ', 1.., �> <br /> ,.,, <br />