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NOTE: PULL <br /> ALL PEXfS SEPTIC, WELL ETC...) NKE COPIES FOR FILE <br /> LAND USE REPORT APP#— 0A—�(6� <br /> EIiD RECEIVED APP.REFERRAL: COMPLETE &C SUBMIT BY�_�Z&J—L <br /> DAT AT <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 /> ill V� �G-vS,rS y G= <br /> �177��irl <br /> I ' <br /> I recommend: ApprovalDenial Continuant Inspector's Signatu rt <br /> 9e*irdsa�*atidc9c-h3sk�r�e1c�F.�9cdckasx�cirir3cdc�k�e�e�'e3r3cicvF�e�ea�c�cic�c�'e�r�cate�r�c�ka�r .e�eie�kixk�E�F�rie�cicicdc�k�'c�eacic9cdc$r$r�e ir9c�cas�eJcic�cis�txxitic <br /> Supervisor/LeadSenior Comments:Y <br /> P-rc) ;L r ' <br /> C- : 0 9 <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> 'OA II CHECK O `F LIST 'Proofread report Carred LAND.USE#9 <br /> £!106 D6 Rev 1199 ' ; Correct CONDITION(S) ` Lagged in <br /> LAND.USE SOOK� <br />