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65 <br /> NOTE: PULL ALL PERMITS (SEPTIC, WELL, ETC...) N)ZaKE COPIES FOR FILE` <br /> LAND USE REPORT <br /> ^^ APP# <br /> EHD RECEIVED APP.REFERRAL: oC - —� COMPLETE & SUBMIT BY <br /> DATE DATE <br /> ATTN: , 9 V- %S - <br /> SITE ADDRESS: 74 a S "cl ± CA <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: N14 Public sewage: "A <br /> SUMMARY OR COMMENTS: <br /> & 2 - o z <br /> 7 /U 2— O 'f <br /> `o 2 S <br /> I recommend: Approval Denial Continuance Inspector's Signatur <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> FEOA�IICHECK OFF LIST: " Praojread repo 7LAND <br /> =BOOK? <br /> EH 06 06 Rev 1/99 _ / Correct CONDITION(S)? Logged <br />