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NOTE: PULL ALL PERMS (SEPTIC, WELL, ETC...) E COPIES FOR FILE <br /> i <br /> LAND USE REPORT APP# <br /> EHD RECEIVED APP.REFERIL4L Uz COMPLETE & SUBMIT BY 5 _ <br /> D FE MATE <br /> ATTN: LW 1A a L,0 <br /> i <br /> /'InSITE ADDRESS: 2 g F //'0- <br /> In <br /> 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 /> I recommend: Approval Denial Continuance Inspector's Signature <br />� $c is 9r�r�9cx$c it kF ie*3c do is*dc arc k�r�ic 9rxxx9e$e keF ie is xicxar is drzc ie do 3c kie do de is'r�c�c 9rK�F��se F r't$e�e kxaF�e$e�r ai Mfr a43c k�enn k�e 4e 9e a'e'e k dr$e*9r do:�:E'x <br /> Supervisor/Lead Senior Comments: <br /> If <br /> /1•c�rti, <br /> 4. <br /> t V— /fZ + <br /> on <br /> 4 <br /> SUPERVISORILEAD SENIOR APPROVAL: + k. <br /> V <br /> OA II CHECK OFF!,, Praafread reports Cor'r'ect L.�IND USE#? <br /> ._. r G'vrrect CONDITIONS ? � .'`:La ed rn LAND USEBQOI1 <br /> EH 06 06 Rev 1199 �� �'. <br />