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L� <br /> NOTE: PULL ALL PERNITTS (SEPTIC, WELL, ETC...) IVXr KE COPIES FOR FILE <br /> iO'e — <br /> LAND USE REPORT oD <br /> EDD RECEIVED APP.REFERRAL COMPLETE & SUBMIT BY 3/3/ Q y <br /> D DA <br /> ATTN: f <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 aria <br /> showing population density, location of house, wind direction, etc.... <br /> Public water: Public sewage: '"� <br /> SUMMARY OR COMMENTS: <br /> VLd I recommend: Approval Denial Continuance Inspector's Signa <br /> Supervisor/Lead Senior Comments: <br /> ' a <br /> r _I� _L • fM.�[ <br /> . E <br /> aa : a <br /> SUPERVISOR/LE D SENIOR A PROV L: <br /> �� - OA II CHECK OFF LIST: _Proofread report? Correct LAND USE#? <br /> Correct CONDITION(S)." _Logged in LAND USE BOOR? <br /> EU 06 v 1/9� <br /> rW�lf•L• <br />