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: NOTE: PULL ALL PERM-,'S (SEPTIC, WELL, ETC...) ff,,\,KE COPIES FOR FILE <br /> LAND USE REPORT APP# <br /> EHD RECEIVED APP.REFERRAL: <br /> I "o "6) COMPLETE & SUBMIT-BY <br /> DATE ff DATE <br /> ATTN: i <br /> SITE ADDRESS: M G� a <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 /> I recommend: Approval Denial Continuance Inspector's Signature <br /> Supervisor/Lead Senior Comments: <br /> i <br /> s <br /> SUPERVISOR/LEAD SENIOR APPROVAL: _ <br /> k "A, 141 „ 9 <br /> OA'1'I CSEGIC OFF Troofread reparl? orreM LAND 1rIS # <br /> ` orrwt Cf�ND�I'TION{S)9 ,Logged tri L 4ND USS BOOK? a <br /> EH 06 06 Rev 1199 <br />