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NOTE: PULL ALL PERM7""S (SEPTIC, WELL, ETC...) I """"IKE COPIES FOR FILE e6 <br /> a ; <br /> LAND USE REPORT APP# -O �2-.2 (3 C <br /> EHD RECEIVED APP.REFERRAL: 5-D --Q COMPLETE & SUBMIT BY K <br /> DATE DATE <br /> ATTN: <br /> SITE ADDRESS: <D <br /> In completing the Land Use investigation, draw all Public Health factors on the e bit(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 /> �r�r�Yx�tir�'e�rde�Fatr�F9eiroE*i�dc��eic�iedrie�k�fa'e�e�c��c9edex�k�e�F�c�k�c�'eie9c�ek*Jrhe:k�e3ek�k:tr4r�'Irx�r9eetr�coEoF:F�e�c�F�c�ciaBe�F�k9c�c9r�r�x�r�rx��x�r�c4eSr�r <br /> Supervisor/Lead Senior Comments: <br /> 1,02 <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> ,�A1Y,Q USE#� <br /> EM 06 06 Rev 1/99rs <� � (! �C 1ik�l�ION(,5` $ gged f15E BUU1Cs <br />