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LAND USE REPORT APP# ,J. A --q 0I ~/ <br /> EHD RECEIVED.SPP.REFERRAL: 3 -8 -5q COMPLETE & SUBMIT BY /4s/ <br /> DATE DATE - <br /> ATTN: a e <br /> SITE ADDRESS: LC <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 reap of area <br /> showing population density, location of house, wind direction, etc.... <br /> Public water: Public sewage: <br /> SUMMARY OR COMMENTS: <br /> 1 recommend: Approval Denial Continuance Inspector's Signature <br /> x�Exk4cirdca�rkiciricfeirxx�c�k�cic�x'x$r�F�ede�F:EaF�rit�t�c�e�'e�'tdeicdtde�F�c�cdcvE�k�rdc�ex�fcicirxie�cicxx�kiririrxxica'riralydrisxaeieieir�ciricieir�iieiciei�ieieie <br /> Supervisor/Lead Senior Comments: <br /> f <br /> 7ElLAD USE CHECK OFF LIST: <br /> id you proofread the report? <br /> SUPERVISOR/LEAD SENIOR APPROVAL: DA YOU USE THE CORRECT: <br /> and Use#? <br /> ondition(s)_VD #? <br /> id you log it as completed? <br />