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LG- <br /> NOTE: PULL ALL PERM,S (SEPTIC, WELL, ETC...) 1\,.,KE COPIES FOR FILE <br /> LAND USE REPORT 7 APP# /'Oj- fat/s/�� <br /> Fun RECEIVED APP.REFERRAL: �+' / COMPLETE & SUBMIT BY ( <br /> DA DATE <br /> ATTN: <br /> STI•E ADDRESS: <br /> In completing the Land Use investigation, draw all Public Health factors on th 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 /> I recommend: Approval UX Denial Continuance Inspector's Signature <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA I!CNF.CK OFFLIST: _Proofread report? Correct LAND USE#? <br /> EH 06 06 Rev 1/99 Correct CONDITION(S)? _Logged in LAND USE BOOK? <br />