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NOTE: PULL ALL PERIVi—:S (SEPTIC, WELL, ETC...) T �KE COPIES FOR FILE <br /> APP# c n <br /> LAND USE REPORT <br /> I,0 - 0 I <br /> -(X-d/ COMPLETE & SUB MIT BY DATE <br /> EI{D RECEIVED APP.REFERRAL:DATE <br /> ATTN: <br /> tfenc � <br /> SITE ADDRESS: <br /> In completing the Land Where investigation, <br /> on an attached piece lth of plainrs on the p per, draw completed map ofarea <br /> water Supp <br /> showing population density, location of house, wind direction, etc.... <br /> Public water: Public sewage: <br /> SUMMARY OR COMMENTS: <br /> i <br /> I recommend: Approval Denial Continuance Inspector's Signature c <br /> Supervisor/Lead Senior Comments: <br /> C, <br /> SUPERVISOR/LEAD SENIOR APPROVAL: -<a' <br /> OA II CfIECK OFF LIST.• Proofread report? Correct LAND USE#? <br /> EH 06 06 Rev 1/99 Correct CONDITION(S)? Logged in LAND USE BOOK? <br />