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NOTE: PULL ALL PERN.d S (SEPTIC, WELL, ETC...) it ,,dKE COPIES FOR FILE <br /> LAND USE REPORT APP# " A - �w- GI <br /> EFID RECEIVED APP.REFERRAL: I Ja/ COMPLETE & SUBMIT BY ��/ o 0 � �J <br /> DATE DATE <br /> ATTN: 1 L% , <br /> SITE ADDRESS: $14 q � "- LT42 Iq d FC 12�1 <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: ��,t/_ �y� <br /> I recommend: Approval_X Denial Continuance Inspector's Signat <br /> *,a*,t,r*r*****rra�*;.�*****,t,t>E***,��**r,t*,ttra�*�**i.*r.,t****,t,t�m*,t*«�**,r,t,t*� ** •�*�*,tr*,t*�,ta <br /> Supervisor/LeaddSe1nioTTr Comments: <br /> Y <br /> `lam- rcu vte awo <br /> or <br /> SUPERVISOR/LEAD SENIOR APPROVAL: �, <br /> OA II CHECK OFF LIST: Proofread report? Correct LAND USE#? <br /> EH 06 06 Rev 1/99 <br /> Correct CONDITION(S)? Logged in LAND USE BOOK? <br />