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NOTE: PULL ALL PERMITS (SEPTIC, WELL, ETC...) MAKE COPIES FOR FILE <br /> LAND USE REPORT APP# -,' A - CAq -c10 <br /> EHD RECEIVED.APP.REFERRAL: EII 11Ct(1 COMPLETE' & SUBMIT BY �� I 1 <br /> D <br /> A DATE <br /> ATTN: 'e" <br /> SITE ADDRESS: 28225 L— . I.oOYYIi� <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 /> Cr4L W4er v/�rope�eo>7n�-hogs <br /> Public water: hlnn,o a+ Public sewage: v1E 5 <br /> SUMMARY OR COMMENTS:Tµ'y a-,me . <br /> Cc fI ' D1 T I{� ll,s &Y Pilo ky-0 Lu&f, -e V7 hot <br /> Deye(oorne,-1 T� Nc- Sec �;oma �- � IIs,B " �r�LtlhiFpd U.s s fie ) <br /> SePara6e WO-1, . 7 �e D�O�'iS ry of Wa�,r fa a vBS; dPwGL= - 'ram a), o4 -5i� <br /> Oft✓e{-e cl0mes��c wuk� watt �nca(e� ,1,n A s�mra �e retail dei oars . � <br /> T�1.5 -tnn=ffSi_bQY�Ce is C1.rren {{7 CohK��(� � ay�oul�rz res dewf e S <br /> bye,(( om i/l/s4"7L"e 'C��, Q �'rb 1�1 i�o i i��l 1A56 . <br /> ` u�l <br /> I recommend: Approval Denial v Continuance Inspector's Signature Ajtr=�-61N� <br /> Supervisor/Ld Senior Coptments: <br /> SUPERVISOR(L.EAD SENIOR APPROVAL: <br /> OA 7I CHECK OFF LIST.• _Proofread reporfe _Correct LAND USE ? <br /> EH 06 06 Rc 1/99 Correct CONDITION(S)? Logged in LAND USE BOOK? <br />