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+NOTE: PULL ALL PERI` TS (SEPTIC, WELL, ETC...),,.wAKE COPIES FOR FILE <br /> LAND USE REPORT APP# LA <br /> EIiD RECEIVED APP.REFERRAL: 07 <br /> DA ool COMPLETE & SUBMIT BAVFDI-E�Q/ V. <br /> ATTN: <br /> / <br /> k) mhor1 .l 4�,t Ila Z <br /> SITE ADDRESS: i9i01 112, r <br /> rLr/7� Limn /z0ad 7rz? rtn <br /> In completing the Land Use investigation, draw all Public Health factorson�xhibit (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 /> I recommend: Approval Denial Continuance Inspector's Signature <br /> \ Supervisor/Lead Senior Comments: <br /> 0 <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA//CHECKOFF LIST. _Proofread report? _Correct LAND USE N? <br /> Ell 06 06 Rev 1/99 _Correct CONDIT/ON(S)7 _Logged in LAND USE BOOK? <br />