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TED <br /> NOTE: PULL ALL PERMITS (SEPTIC, WELL, ETC...) MAKE COPIES FOR FILE <br /> G P - 'I 9 -0s/2tl�- 99 -off <br /> LAND USE REPORT APP# vP- 99 -/a <br /> EHD RECEIVED APP.REFERRAL:4. -.,9I COMPLETE & SUBMIT BY 6 --30 — 99 <br /> DATE DATE <br /> ATTN: � , voma <br /> SITE ADDRESS: ely-i-e r 2d. ✓��'�r 1a� <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 /> � D y <br /> v Z.a 2 <br /> .2 <br /> I recommend: Approval Denial Continuance Inspector's Signature ,� , <br /> x is F is F�cx*fir it F rc*ir* F is is ix is�'cic*icxxicxcXxic�c is ixxxF ie is�c ix ic>c�c is�c�cxic*x* F c is ie�c is is ie it is iexicz�c ir:F*xic ie**it sir eR icxic Lexie�e ie�F 9r <br /> Supervisor/Lead Senior Comments: <br /> Ci <br /> J <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA H CHECK OFF LIST: Proofread report 9' Correct L4ND USE#? <br /> EH 06 06 Rev 1/99 _�Correct CONDITION(S)? Logged in L4.,VD USE BOOK' <br />