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NOTE: PULL ALL PERMS-rS (SEPTIC, WELL, ETC...) 1Vr:KE COPIES FOR FILE <br /> LAND USE REPORT APP# h✓� -U a 35�� '9� <br /> EIID RECEIVED APP.REFERRAL: ' O _ COMPLETE & SUBMIT BY A S , R F) G-Z <br /> DAT / DATE <br /> ATTN: <br /> SITE ADDRESS: �La <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 /> --1 <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> **�xx*x+xx�xxtxxxx*xxx�xx�xxxxnxnx**xxxx*x�x**x*xxx�*x*x*xxxxxnxx**xKx*x*n*x***xaKxx*xxnx� <br /> Supervisor/Lead Senior Comments: <br /> i/ t, <br /> , oS- <br /> (3 �n 4;� a4----a.P A <br /> I > a.+aDucf.+�i ati.� 3 L �iAQ zl4Q i F uk purr <br /> a ',A,& <br /> S. <br /> SUPERVISORILEAD 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 /> I <br />