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NOTE: it ULL �LL PEA1% 'SEP tC, " e .L, -TC KE COPIES FOR FILE <br /> LAND USE REPORT APP# <br /> nn� L c <br /> I a' COMPLETE & SUBMIT BY r2 - 6—VZ <br /> EHD RECEIVED APP.REFERRAL: DATE <br /> DAT // <br /> Gt /1 e� <br /> ATTN: Sk- <br /> 1 )b i <br /> SITE ADDRESS: a en <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 /> I recommend: Approval Denial Continuance Inspector's Signature <br /> Supervisor/Lead Senior Comments: Qp <br /> ::ESUPERVISORILEAD SENIOR APPROVAL: <br /> OA 11 CHECK OFF LIST proofread report? Correct LAND USE#? <br /> Correct CONDITION(S)? _Logged in LAND USE BOOK? <br /> EH 06 06 Rev I/99 <br />