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CZPYLTC , <br /> NOTE: PULL ALL PERMrr-S ( ...) Mrrt�E COPIES FOR FILE <br /> LAND USE REPORT APP# 1Y15-a'�-d� Y- LR-On_ -y/ <br /> EHD RECEIVED APP.REFERRAL: —00- COMPLETE & SUBMIT BY <br /> DATE DATE <br /> ATTN: A I-tJn�Y1� l <br /> SITE ADDRESS: * �Z(o /l �e Z 2 ,' 2n�Gt , ,� 4r,- <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 /> �u <br /> 1 <br /> � L <br /> !SCS <br /> I recommend: Approval Denial Continuance Inspector's Signature �2j <br /> Supervisor/Lead Senior Comments: <br /> m5_ o <br /> V <br /> /w� ��I/�W� woo E o.� <br /> .' • • I /� y Y/ �. <br /> �.,�. ,.{l`L <br /> v O 0 - D <br /> SUPERVISORILEAD SENIOR APPROVAL: <br /> P <br /> OA II CHECK OFF LIST: Proofread report? Cor. <br /> EH 06 06 Rev 1/99 Correct CONDITION(S)? Logged In LAS <br />