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NOTE: PULL ALL PER1N,,.,S (SEPTIC, WELL, ETC...) 1...*'KE COPIES FOR FILE <br /> LAND USE REPORT APP# P/ -0 -J--2Z Z51) - <br /> EHD RECEIVED APP.REFERRAL: q—I--Q J, COMPLETE & SUBMIT BY <br /> DATE <br /> DATE <br /> ATTN: (� S <br /> SITE ADDRESS: ) Q �] f= /rv) <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: <br /> SUMMARY OR COMMENTS: <br /> - GO-- <br /> 0 <br /> I recommend: Approval Denial Continuance Inspector's SigFW <br /> Supervisor/Lead Senior Comments: <br /> ca� 6 <br /> iLl <br /> SUPERVISOR/LEAD SENIOR APPROVAL: ,.', <br /> OA II CHECK OFF LIST. Proofread report? Correct LAND USE#? <br /> EH 06 06 Rev 1/99 Correct CONDITION(S)? Logged in LAND USE BOOK? <br />