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K� <br /> NOTE: PULL ALL PERMhIS (SEPTIC, WELL, ETC...) MAKE COPIES FOR FILE <br /> ,g�Q,UrS���h of <br /> LAND USE REPORT APP# - q� " ►4c <br /> EHD RECEIVED APP.REFERRAL: Z COMPLETE & SUBMIT BY qZ I aZ d Z <br /> 15ATY DAT <br /> ATTN: <br /> SITE ADDRESS: logSCS <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: <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA II CHECK OFF LIST., Proofread report?. - - Correct LAND USE#? <br /> EH 06 06 Rev 1/99 Correct CONDITION(S)? Logged in LAND USE BOOK? <br />