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NOTE: PULL ALL PERI TS {SEPTIC, WELL, ETC...}Q-AKE COPIES FOR FILE <br /> LAND USE REPORT APP# 305 L,4 <br /> EHD RECEIVED APP.REFERRAL: '-?-)1'02- COMPLETE & SUBMIT BY 7 - / '� -0-2 <br /> DATE DATE <br /> ATTN: <br /> SITE ADDRESS: p, <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 /> llSUMMARY-011 COMMENTS: <br />' a o - <br /> 0. <br /> s <br /> I recommend: Approval Denial Continuance Inspector's Signatu <br /> '!e^k9e9t*ic c*iritis****isicx <br /> Supervisor/Lead Senior Comments: <br /> OF if <br /> 33 Aa4al <br /> cctix.J�- <br /> SUPERVISQRILEAD SENIOR APPROVAL: _ <br /> s l ` W w4A II CHECK©FF L.IST Proofread report?�Correct.AND USE#9 <br /> EH 06 06 Rev 1199 Y m Carred CQNDITIUNj x.. Lugged rn LAND USE BODK� , <br />