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f <br /> NOTE; PULL ALL PERMITS (SEPTIC, WELL, ETC...)'14AKE COPIES FOR FILE <br /> LAND USE REPORT / APP# .S A —9 9— 7Z <br /> EHD RECEIVED.APP.REFERRAL: 10-6'q0 COMPLETE & SUBMIT BY / O - / ? - ?9 <br /> DATE DATE <br /> ATTN: JyA(-` F-IsA e✓ <br /> SITEADDRESS: 9911S" Al, Cot.Uer- 5acr--Me1-) ><0 led— .5.4klt <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: /✓bN& Public sewage: X61))E7 <br /> SUMMARY OR COMMENTS: <br /> 0 b( <br /> I recommend: Approval_ Denial Continuance Inspector's Signator �HncaG� <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA !/CHECK OFF LIST: _Proofread report? _Correct L4ND USE#? <br /> EH 06 06 Rev 1/9 Correct CONDITION(S)? Logged in L-04D USE BOOK? <br />