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Tt: PULL ALL PE 'S SEPTIC, WELL, ETC...) aE COPIES FOR FILE <br /> NO { <br /> LAND USE REPORT APP# o3—(0� <br /> EHD RECEIVED APP.REFERRAL. COMPLETE & SUBMIT BY <br /> DAT jo DATATTN: <br /> SITE ADDRESS: 945 �5, ,02 e--L )M- Ckht�� <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 /> 4c-'�v ,+-Po <br /> i r G� <br /> I <br /> 02, <br /> I recommend: ApprovaQ.A�Denial Continuanc Inspector's Signatu <br /> **�cFx***�r�k*****�'c-9c�[F�e*irxiir*af*is*�Fx�rx**eF�cvk*F*9t�c�e*k9e* �e9riric***a�ckir�'t$r�e�e*�c9c3cir***�t�: *Fx�iic�s**�tR�eiricx* <br /> Supervisor/Lead Senior Comments: <br /> C. <br /> X2:01 <br /> SUPERVISORILEAD SENIOR APPROVAL: ! <br /> OA 11 C�TEIC©F LIST s :Prvofreud report ''` Correct LAND,USE#' <br /> FD o6 06 Rev t19 Correct CUNDITIONO Lvgged'rn'LAND�USE BOOKS „, <br />