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w <br /> NOTE: PULL ALL PERMITS (SEPTIC, WELL, ETC...) MA�`E COPIES FOR FILE <br /> LAND USE REPORT APP# <br /> EIIDRECEIVED APP.REFERRAL: 0—al C)2-- COMPLETE & SUBMIT BY T�U� <br /> DA I AT <br /> ATTN: KI A11reA/_`�'li��'�l✓r�� <br /> SITE ADDRESS: 0 (� t� �7 <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 /> I recommend: Approval Denial Continuance Inspector's Signature <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISOR/L,EAD 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 />