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NOTE: PULL ALL PERMhRIS (SEPTIC, WELL, ETC...) MAKE COPIES FOR FILE <br /> LAND USE REPORT APP# P,40,D - 3 <br /> EHD RECEIVED APP.REFERRAL: <br /> --jLJa COMPLETE & SUBMIT BY <br /> DA �J TE <br /> ATTN: i C4 tq e <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 area <br /> showing population density, location of house, wind direction, etc.... <br /> Public water: Public sewage: <br /> SUMMARY OR COMMENTS: <br /> e-W <br /> 2 � � <br /> f%j?!'i2 '�Z C1.✓.S✓3�G71 4L S�16G,/I�bldT� �^'� <br /> �� 'r5�! -�. iUJ,�7ic.sr.(��s lc��t.4.�aJ acv>r/7lfEs,ST�zdIF luo BG� <br /> act <br /> ZZ:o <br /> � ,c /�dY/,tu7c�Yc.��'��oe�i'lU�l>r 9�•�zc���Yz�c..6 &�e� <br /> I recommend: Approval ✓ Denial Continuance Inspector's Signat <br /> Supervisor/Lead Senior Comments: <br /> 0 y a8 2sc 3 <br /> P +'Y <br /> �� e6 <br /> D <br /> SUPERVISORILEAD SENIOR APPROVAL: <br /> F <br /> A II CHECK OFF LIST: _proofread report? <br /> ICorrect USE BOOK? <br /> Correct CONDITION(S)? —Logged <br /> Ef 106 06 Rev 1/99. -- <br />