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NOTE: PULL ALL PERU <br /> ITS SEPTIC, WELL, ETC QISE COPIES OR FILE <br /> � o - � � <br /> LAND USE REPORT APP# SP41 <br /> EHD RECEIVED APP.REFERRAL: I COMPLETE & SUBMIT BA R AR1 <br /> DAT DATE <br /> ATTN: <br /> SITE ADDRESS: c) 61 <br /> In completing the Land Use investigation, draw all Public Health factors on the exhibit (i.e.: sewage disposa , <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: J' <br /> SUMMARY OR COMMENTS: <br /> I recopp <br /> mmend: Approval Denial Continuance Inspector's Signature -, <br /> �e*fir�c F%1exr.-h of 4e keF is k$c�e 9e$eic*dc 4e�kair$rxkic F of F�e rx*ie 9exic k 9t$ede$ie 3e�e ie�r of�r 9c*%�LF4e�e k iaFaex4c de$t irx�c*ii do ie 4s!e�t it ie�c ac itxir is iex�e <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISORILEAD SENIOR APPROVAL: <br /> " Proo read re ortF Correct L IND i/SE#9 <br /> ` ':`Correct CDNDITION(S)7 �°' `' Logged in LANA USE BODX <br /> Eli 06 06 Rev 1199 <br />