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;NOTE: PULL ALL PEW TS (SEPTIC, WELL, ETC...) N' KE COPIES FOR FILE <br /> LAND USE REPORT APP# n <br /> EHD RECEIVED APP.REFERRAL: 9 0� COMPLETE & SUBMIT BYA.�A .x V' 1 aS a <br /> DA <br /> %tr4T .1 1 � <br /> ATTN: <br /> SITE ADDRESS: 7 ` <br /> In completing the Land Use investigation, draw all Pub is Health factors on the exhibit (i.e.: sewage disposal, <br /> water supplies, etc...). Where necessary, on an attached piece of plain paper, draw completed reap of area <br /> showing population density, location of house, wind direction, etc.... <br /> Public water: no Public sewage: hD <br /> SUMMARY OR COMMENTS: <br /> IV' <br /> I <br /> � zz:o6 <br /> ' I recommend: Approvals Denial Continuance Inspector's Signatnr <br /> dr 3c*fir**fir****fie****�s tc***********ic it is it it ie it is�e is�F a'e dr�r nk*a'ca'r'e�e*k�c�t$ckic***z'c k it*�c ac vk is*�c is�r it i��c�r�fc9r rx**�c�r it de*ie* <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA II CHECK OFF LISW;`N 4d:i4ora L 4 DISE# <br /> r a <br /> EH 06 06 Rev 1199 Correct CONR&1QN(SJ Lagged an LAND USEBOOKS <br /> r <br />