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NOTE: PULL ALL PERMITS (SEPTIC, WELL, ETC...) MAKE COPIES FOR FILE <br /> LAND USE REPORT APP# a-Q3-y� <br /> EHD RECEIVED APP.REFERRAL �23COMPLETE & SUBMIT BY 7�/ E 3 <br /> DATE z Z DAT <br /> ATTN: `��✓vU�� <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 /> I recommend: Approval Denial Continuance Inspector's Signatu <br /> Supervisor/Lead Senior Comments: <br /> d <br /> SUPERVISOWLEAD SENIOR APPROVAL: <br /> OA II CHECK OFF LIST: _Proofread report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE BOOK? <br /> Ef 106 06 Rev 1/99 -- <br />