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rill <br /> 'NOTE- PULL ALL PERMJTS (SEPTIC, WELL, ETC...) EKE COPIES FOR FILE <br /> REPORT APP# " ��`' % �G>9 <br /> LAND USE R <br /> A0 <br /> 1. — �� <br /> EtID RECEIVED APP.REFE42RAL: E COMPLETE & SUBMIT ' _1 DATE <br /> ATTN: le'l IF <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 paper, draw completed map of area <br /> showing population density, location of house, wind direction, etc.... <br /> Public water: Public sewage: i 7 <br /> SUMMARY OR COMMENTS: <br /> l_ <br /> X01,�� <br /> C5?Q <br /> S <br /> I recommend: Approva FDenial Continuance Inspector's Si atur .� <br /> Supervisor/Lead Senior Comments: <br /> o�01r03 ��dl.� <br /> all ii <br /> ,743 <br /> i <br /> o(o <br /> SUPERVISORILEAD SENIOR APPROVAL: <br /> OA_II CIIECIC DFFLIST . ` Proofread reports 'Corre�cl LANI3,USE#9 <br /> Correct CONDITIONS) `" Lagged rn LAND USE BOOK <br /> E106 06 Rev 1199 <br />