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LG <br /> NOTE: PULL ALL PERNTiTS (SEPTIC, WELL, ETC...) NlnKE COPIES FOR FILE <br /> LAND USE REPORT APP# 19 7" <br /> ^/ //'�� �777��r///P��� v., -�.',�7 <br /> EHD RECEIVED APP.REFERRAL:D� `2f V 3 COMPLETE & SUBMIT BY Lam:' „+.3,dam° <br /> �7 J <br /> ATTN: 7` hn/1 -d i 0 <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 /> SUM AR COMMENTS: <br /> (Z-� <br /> G <br /> -ate <br /> J J <br /> I recommend: Approval Y Denial Continuance Inspector's Si <br /> �>k�*x*x�a�*��:�xx�***x�*.x*nx�xx�xxxxxaxxxxx��*xxxxxx�K�*xnxx+xxx,�,��*•x *�>E� :�**:�*Fx�>E�**xx <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISORILEAD SENIOR APPROVAL: <br /> OA 11 CHECK OFF LIST: _Proofread report? Correct LAND USE#? <br /> EH 06 06 Rev 1/99 Correct CONDITION(S)? _Logged in LAND USE BOOK? <br />