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rel <br /> NOTE: PULL ALL PERMITS (SEPTIC, WELL, ETC...) MSE COPIES FOR FILE <br /> LAND USE REPORT APP# 514 - 99 -2,c) RE— 6-5 0 <br /> EHD RECEIVED APP.REFERRAL: -of —OJ COMPLETE & SUBMIT BY '7 - 31 - 00 <br /> DATE DATE <br /> ATTN: -1 i nCa JA )o roa p ' kc <br /> SITE ADDRESS: ) E) U I A) L WSnj�-- ,� Ac-cek AN4,1 Q 2 c)n . <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: /Ud <br /> SUMMARY OR COMMENTS: <br /> m5mwit �e Z <br /> � -� �fla� IUF�fS T✓ansr ( /t)U✓t �arHiYu�r��, WATT <br /> S s� � vr�la/dam . And Warc�r- �'urJ�� <br /> I recommend: Approval Denial Continuance Inspector's Signature Q <br /> Supervisor/Lead Senior Comments: <br /> �d 1. <br /> g ii • o3 <br /> �C. H:©/ <br /> D o Y <br /> a ao=V <br /> 0'? <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> �^ °�� �� OA II CHECK OFF LIST: _Proojiead report? _Correct LAND USE#? <br /> EH o6 U6 Rev 199" Correct CONDITION(SJ? Logged in LAND USE BOOK? <br /> /.S 0 1 <br />