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NOTE: PULL ALL PERMITS (SEPTIC, WELL, ETC...) MAKE COPIES FOR FILE <br /> LAND USE REPORT APP-9 <br /> �—7--99 COMPLETE & SUBMIT BY /�� 4 9 <br /> EHD RECEIVED.APP.REFERRAL: 1 <br /> w- DATE / DAT <br /> ATTN: J� fYA V G. (I 15U re-o <br /> SITE ADDRESS: c Pi <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: _ /y Public sewage: <br /> SUMMARY OR COMMENTS: <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> iez*x*ie****pie*aux*9e***Ir pie*******************ie*ic ie ie ie***x*dei'e it ie de 3e ek*de*ie�e de ie de 4e ei Je de 9r***dc*9r*�c*ie**.* of**** <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> T[OA CHECK OFF L[ST. ' oojreadreport9 Correct LAND USE#t' <br /> £!d 06 06 Rev 1199 arrectCON T10N(S} Logged in LAND USE BOOK?. <br />