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NOTE: PULL ALL PERi*,ITS (SEPTIC, WELL, ETC...) MAKE COPIES FOR FILE <br /> LAND USE REPORT (y APP# . S(///Ay��� -�A9y9D5( <br /> EHD RECEIVED APP.REFERRAL: -II- /�jq COMPLETE & SUBMIT BY J" 4W <br /> DATE JJ-- DAT17 <br /> ATTN: <br /> SITE ADDRESS: i -;�l <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: CAL WArEP­ Public sewage: art�—" <br /> SUMMARY OR COMMENTS: <br /> N 1 <br /> G C?vAA'TT OF FLYASF4 /Cga05 E:J To i-.t= 9'ro2t=,� -r415 Ln -r, A 4iF � <br /> 1 T1 E DE T" 1 <br /> F lAZf12UDV5 tyA5'r�AGcpP_4 i.�/ To � TLE ZZ. G4/�F�1lA conE pF�(VLATi o..i5 � eI i s+eo�wws+g <br /> !n Ti+Ie ZZ or ;Ff'he,rwas+a elch"6'jShararclovs rAarwcfEr s4-Lr6 +gb:l:+, /prros;vl�h/r -4;V; � <br /> 0I"Fo)c;c <br /> A% n A or <br /> \_� <br /> TiiXrL Sl�(SS'rANLt.S Gon,-rL0 � Giia Ue2E <br /> o IOZ. 0 1, o 0 <br /> -. <br /> --1 - rTFIE /4A°Ltca,.�T e,.T,ou-s E. A. 0�- S.c. <br /> E C <br /> ,. ,r,AS+ lA4,5,-/(4-r'?0,1 iEvaeVAo tOAI wH -,o}r (a+6) 322- 7 676 Ty 0C-1v,1stS4TE -r44—, - J/ <br /> [ recommend: Approval Denial Continuance Inspector's Signatu ��e— <br /> "rA it A FLYJ S5-I o-r 9 wAG- e-( oQ SF Z� 7s EYE/,P'r FCD, <br /> /LF6(.wr.oµ. Tr1 E ACPaI(�Y <br /> Snow 9!./isL.'+.AdTT 5=F rl ca AFi�B4Arrvr��C-r'I E e�44 AGL'r,oA Wo• F.' . 0+5c.TO+ll1 r4i o FFrL` <br /> Supervisor ea error ommeatse ------ <br /> t i IX 5FE-r -rAE O Glrl! r,,j or A /Ar4leD042S ^Ar< A c< ro 'r'.1F <br /> C rf !A SAff>Y CcrJf, G+J9 -r-df o oL1l <br /> �J 0 I On\E77 C -rrl <br /> a��,BGe aF FsrPaoY�S trPfos Ti 1 r .lE Sfprr� sr3>F/rf+�r�L� :z> <br /> arse n, t ,late P r d i— szrcn oa R5 nlr4 oan� <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA 11 CHECK OFF LIST: Proofread report? _Correct LAND USE#? <br /> H 06 06 Rev 1/99 _Correct CONDITION(S)? _Logged in LAND USE BOOK? <br />