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LAND USE REPORT '�, APP# <br /> EHD RECEIVED APP.REFERRAL: `� r�� COMPLETE & SUBMIT BY <br /> .. DATE DATE ii 1 <br /> ATTN: <br /> SITE ADDRESS: <br /> In completing the Land Use investigation, draw all Public Health factors on the exhibit (i.e.: sewage dispiasal, <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 /> i <br /> Public water: Public sewage: <br /> SUMMARY OR COMMENTS: <br /> I' <br /> r <br /> II <br /> �I <br /> I <br /> i <br /> 00 <br /> ii <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> dr it 9r�e�F$$x�e kir kir%�c ie�e ie ndr*�E*****�xdc ac�'sXe4ze it a�xx�kaFxdr 9e��c de is i'cir:F�r ak�r 9e�e 4exiexiexvY�c�irx ie ie dr dcs:F 4c kdc is ic�dr is is ie x�xie ie <br /> Supervisor/Lead Senior Comments: <br /> i <br /> LO <br /> i <br /> i <br /> I <br /> �I <br /> it <br /> I <br /> I� <br /> I <br /> LAl�1D USE CHECK OFF LIS <br /> SUPERVISOR/LEAD SENIOR APPROVAL: I Did you proofread the report <br /> Dp YOU USE THE CORRECT:: <br /> ✓ Land Use#? <br /> Condition(s)#? <br /> ! Did you log it as completed? <br />