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NOTE: PULL ALL PERMTS (SEPTIC, WELL, ETC...) Nr (KE COPIES FOR FILE <br /> LAND USE REPORT APP#_(� <br /> EHD RECEIVED APP.REFERRAL: IIQ16Y COMPLETE & SUBMIT BY A P.py <br /> D TE E <br /> ATTN: l <br /> SITE ADDRESS: 2617-54- <br /> In <br /> 6 S 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: Public sewage: <br /> SUMMARY OR COMMENTS: <br /> I recommend: Approval Denial Continuance Inspector's Signatu ��; <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> DA fir CHECK OFF LIST: Proofredd report? Correct LAND USE#? <br /> k_I100O6Rev 1199 <br /> Correct CONDl'TION(S)7 Logged in LAND USE BOOK? <br />