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NOTE: PULE. ALL PERM'S (SEPTIC, WELL, ETC...) lb_..4KE COPIES FOR FlLfjg;�f <br /> LAND USE REPORT APP# <br /> EHD RECENED APP.REFERRAL: )U� COMPLETE & SUBMIT BY �� <br /> DATE <br /> DATE <br /> ATTN: R, GlC AI ZZZ�l <br /> SITE ADDRESS: 344 <br /> In completing the Land Use investigation, draw all Public Health f�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: � rv— Public sewage: <br /> SUMMARY OR COMMENTS: <br /> 30 • oR 15,/, <br /> G <br /> r C L3k.[ `Jjlu�j i1,LI <br /> � I <br /> �- <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> x,�xxx*+**xx*�x,�x�*:�x:���**�x�x,�*x��x��:�,�*,�*:�:�,��**�**xx�xrs�,t�*,��xxx�,�**�t •. �x **r *�,���*�xt <br /> Supervisor/Lead Senior Comments: <br /> C l,( � 0 3 ✓t-.mak` �, �� ������, �� �' Sem <br /> i <br /> SUPERVISORILEAD SENIOR APPROVAL: <br /> OA I/CHECK OFFLIST: _Proofread report? Correct L4ND USE#? <br /> EH o6 06 Rev "9 Correct CONDITION(S)? _Logged in LAND USE BOOK? <br />