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NOTE: PULL ALL PERMJYS (SEPTIC, WELL, ETC...) M!'KE COPIES FOR FILE <br /> aril <br /> LAND USE REPORT APP# PA - 03 - iNA�� �^"`�``N` <br /> EHD RECEIVED APP.REFERRAL:DAv ( QCOMPLETE & SUBMIT B , D E 03 <br /> ATTN: i <br /> ✓VI, /L S <br /> SITE ADDRESS: )Z I n\ <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: r / <br /> / . �� re J' r4 <br /> S o a <br /> c <br /> I recommend: Approval Denial <br /> Continuance Inspector's Signature <br /> Supervisor/Lead Senior Comments: <br /> s(Lee _ hew, o S— — 3 <br /> oll ntt <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> FOATIWICHECK OFF LIST: _Proofread report?Lo edea oin SND USE BOOK? <br /> Correct CONDITION(S)? SS <br /> I£110606 Rev 1/99 _ <br />