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NOTE: PULL ALL PERl1a,,,,S (SEPTIC, WELL, ETC...) r .,KE COPIES FOR FILE <br /> LAND USE REPORT APP# 6r&d <br /> EHD RECEIVED APP.REFERRAL: A- I —0Z— COMPLETE & SUBMIT BY <br /> DATE DATE <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 pa r, 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 /> Ll V - 1 <br /> I recommend: Approv 1 Denial Continuance Inspector's Signature <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA II CHECK OFF LIST: Proofread report? Correct LAND USE#? <br /> Ell 06 06 Rev 1/99 Correct CONDITION(S)? Logged in LAND USE BOOK? <br />