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NOTE: PULL ALL PERN..-,fS (SEPTIC, WELL, ETC...) KE COPIES FOR FILE <br /> LAND USE REPORT APP# ZA -0/-9S <br /> EHD RECEIVED APP.REFERRAL: Z2 l3 -0 COMPLETE & SUBMI-T B , d`-4Y-W' /ad-0f <br /> DATE DATE _ O t.4- <br /> ATTN: ZeKnne " <br /> SITE ADDRESS: rAP, 6Vd, Skrk/c d <br /> E <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 den i , location of house, wind direction, etc.... <br /> Public water: Public sewage: C_ <br /> SUMMARY OR COMMENTS: <br /> I <br /> i <br /> I <br /> I ` <br /> I recommend: Approval Denial Continuance Inspector's Signaturd-�611-4 <br /> Supervisor/Lead Senior Comments: <br /> I <br /> SUPERVISOR/LEAD SENIOR APPROVAL: ! <br /> 4A II CHLCIC OFF LIST 'roofread report? Correct LAND USEAll <br /> Correct CONDITIDN(S)7Logged to LAND USL BOOK? ` , <br /> EH 06 06 Rev 1199 _ ati <br />