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LG <br /> NOTE: PULL ALL PERMITS (SEPTIC, WELL, ETC...) M�TCE COPIES FOR FILE <br /> LAND USE REPORT APP# Ihy <br /> ,/ <br /> EHD RECEIVED APP.REFERRAL: f 0 COMPLETE & SUBMIT BY I &ZQ�/0...3 <br /> DATE DATE <br /> ATTN: <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 /> Cf , <br /> I C <br /> I recommend: Approval Denial Continuance Inspector's Si <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OAOFF LIST: _proofread report?Lo ed in)r D USE BOLAND O <br /> CoK? <br /> rrect CONDITION(S). g <br /> EH 06 06 Rev 1/99 <br />