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LM <br /> NOTE: PULL ALL PERN&S (SEPTIC, WELL, ETC...) M70& COPIES FOR FILE <br /> AND USE REPORT APP#: PA-04-89 (MS) <br /> EHD RECEIVED APP.REFERRAL: 3/1004 COMPLETE & SUBMIT BY: 4-07-04 <br /> DATE DATE <br /> ATTN: RICK GRIFFIN <br /> SITE ADDRESS: 27570 NORTH MACKVILLE ROAD, CLEMENTS <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 a completed map of area <br /> showing population density, location of house, wind direction, etc.... <br /> Public water: h Public sewage: �O <br /> SUMMARY OR COMMENTS: <br /> ()y <br /> aa-oa <br /> IS <br /> ( aa. o <br /> -P��n ®ii/�!.'C ter-- l��•a2�li �-.�� +ter/ I .sr� ��c �N <br /> n <br /> I recommend: App ova eniall Coo tmuan�e �pect Si air <br /> Supervisor/Lead Senior Comments: <br /> 6 <br /> : d <br /> e. ,t- x..11 r,�►� .�. �.:�, a../ �.». <br /> : C <br /> a <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> �I 06 06 Rev 199 O,f H CHL(X O/7 LIST. Proofread report? Correct L LVD USE#? <br /> Correct CONUI fIOV(S)? Lodged in LAND L SE BOOK? <br />