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NOTE: PULL ALL PERI, 'S (SEPTIC, WELL, ETC...) I KE COPIES FOR FILE <br /> LAND USE REPORT APP# I'9 <br /> EHD RECEIVED APP.REFERRAL: COMPLETE & SUBMIT BY <br /> DATE DATE <br /> ATTN: ct E--s <br /> SITE ADDRESS: 1 Q <br /> In completing the Land Use investigation, draw all Public ealth 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: <br /> SUMMARY OR COMMENTS: <br /> as :oOFa <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> ��*xxx�*x*;x*x**x*x***xxKxKxxx�,�*xx�nxxx£x*xrx�xx;xxx*;**xx�**,�x**F:��x*�xxx***;x�*xFxxxn�x <br /> Supervisor/Lead Senior Comments: I �� t r ' <br /> Oil <br /> rvt.. <br /> SUPERVISORIL,EAD SENIOR APPROVAL: <br /> OA 11 CHECK OFF LIST: Proofread report? Correct LAND USE#? <br /> EH 06 06 Rev 1/99 _Correct CONDITION(S)? Logged in LAND USE BOOK? <br />