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NOTE: -PULL ALL PERMITS (SEPTIC, WELL, ETC...) NSE COPIES FOR FILE <br /> LAND LSE REPORT //�� APP# .sA - r9/ 9 96 <br /> EHD RECEIVED APP.REFERRAL: 1 "1 COMPLETE & SUBMIT BY <br /> DATE IDATE <br /> ATTN: App p FL- L r r� <br /> SITE ADDRESS: 73 ,3 3 N t lA c /c I Gt'\k <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 /> 000 <br /> � " r <br /> ex , --e-. ! �/ Al p �� j�� I e, CZ2:2 TSF <br /> I 0 4eqAC r'1 <br /> c tin <br /> r f s <br /> S e r c -P <br /> —� <br /> r� <br /> 6=ti1`�e tl� <br /> I recommend: Approval Denial Continuance 1000or Inspector's Signatur� � <br /> b <br /> * xxr� <br /> Supervisor/Lead Senior Comments: <br /> A) <br /> SUPERVISOR/LEAD SENIOR APPROVAL: A�. <br /> OA H CHECK OFF LIST: Proofread report? Correct/AND USE#? <br /> EH 06 06 Rev 1/99 _Correct CONDITION(S)? �_Logged In LAND USE BOOK? <br />