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NOTE: 'PULL ALL PERMITS 1`4 21 ,.) 1TAKE COPIES FOR FILE <br /> C <br /> LAND USE REPORT 6 q) �# L f} - 9g -6 3 <br /> EHD RECEIVED APP.REFERRAL: 'ate-"1-1 ! - ! BY4A.5A-P �P - ' 9I 01 <br /> DATE DATE <br /> ATTN: T7 n 6... <br /> SITE ADDRESS: <br /> In completing the L. :wage disposal, <br /> water supplies, etc.. map of area <br /> showing population <br /> Public water: <br /> SUMMARY OR C <br /> J — — — — <br /> !7 <br /> G <br /> I recommend: App <br /> Supervisor/Lead Se: �-- -- P��►+-r-- m— T <br /> ann <br /> CB. the domestic wells shall he located ten(10) feet from the proposed North property lines. <br /> OA H CHECK OFF LIST: Proofread report' - Correct LAND USF #? <br /> EH%IM Rev 1M I Correa CONDITION(S)? Lo,-,-ed in L,-LVD USE BOOK? II <br />