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NOTE: PULL ALL PERMMS (SEPTIC, WELL, ETC...) MA'I{E COPIES FOR FILE <br /> LAND USE REPORT APP# <br /> EHD RECEIVED APP.REFERRAL: 7 �'Od COMPLETE & SUBMIT BY 0 <br /> DATE n DATE <br /> ATTN: ci-ee <br /> SITE ADDRESS: C7 S �C, <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: &M Public sewage: <br /> SUMMARY Olt COMMENTS: <br /> I recommend: Approva Denial Continuance Inspector's Signature <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA H CHECK OFF LIST.• Proofread report? Correct LAND USE#? <br /> EH 06 06 Rev 1/99 Correct CONDITION(S)? Logged in LAND USE BOOK? <br />