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NOTE: PULL ALL PERM,�iS (SEPTIC, WELL, ETC...) Xal COPIES FOR FILE <br /> LAND USE REPORT APP# <br /> EHD RECEIVED APP.REFERRAL: 611 COMPLETE & SUBMIT BY 7 S '03 <br /> DA DATE <br /> ATTN: <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: <br /> SUMMARY OR COMMENTS: <br /> a <br /> I recommend: Approval Denial Continuance Inspector's Sign atur lGc� <br /> �F>c��kaEnF3cick�iie�r$r�k�F�e'x�e3e�ex�'e*9c 4c�Fk*aF:EaE�c:F$c3c9cdc3c�caF*�r�Tcak�rdr9rdr�'cdreF�'c�e�e4c�r�cdcaE�Fdcicis$sicicoYic�ckdc9ckicftak9r*4c isK�exir�e�r$vle�r <br /> Supervisor/Lead Senior Comments: <br /> 6 Y -q <br /> 42 <br /> i! <br />' SUPERVISOR/LEAD SENIOR APPROVAL: <br /> SOA IICHECK IJF,+F DIST, .. Praofrevd report. Correct LAND USE#9 <br /> li EH 05 06 Rev 1199 � Correct CONDITI4 (S)?.' Logged in L�lYD IISEBOOK? <br /> ,z; eau.., • �.u...,;: � �,; <br />