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-(h5S 0� p1ns <br /> SOtr� 5"te- 'd cove-' <br /> NOTE: PULL ALL PERMITS (SEPTIC,WELL, ETC...) MX's.E COPIES FOR FILE <br /> APP# 5 h�� ( 'S <br /> LAND USE REPORT � �/ <br /> EIID RECEIVED APP.REFERRAL: -"b b-o l COMPLETE & SUBMIT BY – �ATE <br /> DATE <br /> ATTN: I ., �� /� S r <br /> SITE ADDRESS: 4C4 � <br /> In completing the Land Use investigation, draw all Public Health factors on the exhibit pleted map of area <br /> e.: sewage disposal, <br /> water supplies, etc...). Where necessary, on an attached piece of plain paper, draw comp <br /> showing population density,location of house, wind direction, etc.... <br /> Public water: Public sewage: <br /> SUMMARY OR COMMENTS: <br /> ' e- <br /> r <br /> � <br /> // /`/ "/�.C7.�/� .�� .�c� r•,b/iY�iiE /nom f z-,l'7l r� � -�f�• .. <br /> 00 <br /> I reconmend: Approval Denial Continuance Inspector's Sign <br /> �ervisor/Lead Senior Comments: 5 JZ 4'0—� TAS <br /> rrri.v <br /> r <br /> SUPERV ORILEA/D SENIOR APPROVAL: <br /> 00 __ OA H CHECK OFF L/ST• _ Pinnjrentl report? Correct LAND USE#? •a . <br /> EH 06 06 Rev 1 __ Correct CONDITION(S)? in LAND U.SE BOOK? ' `14/ <br />