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NOTE: PULL ALL PER MI'1rS (SEPTIC, WELL, ETC...) MAKE COPIES FOR FILE <br /> LAND USE REPORT APP# <br /> EHD RECEIVED APP.REFERRAL: ' I 9_1 qq COMPLETE & SUBMIT BY 1/Y1,2000 <br /> DArI D <br /> ATTN: FS ke r <br /> SITE ADDRESS: ('�OO a L Q r� <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 /> x�-2 7-9q <br /> I recommend: Approval L�/ Denial Continuance Inspector's Signature <br /> Supervisor/Lead Senior Comments: <br /> 1)� <br /> !d91 -b <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA H CHECK OFF LIST: _Proofread report? Correct LAND USE#? <br /> 06 Rev 1/99 _Correct CONDITION(S)? Logged in LAND USE BOOK? <br />