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NOTE: PULL ALL PERMNS (SEPTIC, WELL, ETC...) MAKE COPIES FOR FILE <br /> LAND USE REPORT APP# <br /> EHD RECEIVED APP.REFERRAL: Il l COMPLETE & SUBMIT BY <br /> D E DAIfE <br /> ATTN: � <br /> SITE ADDRESS: <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 /> SU RY OR COMMENTS: <br /> 0� <br /> � 0 <br /> O <br /> I recommend: Approval Denial Continuance Inspector's Signatur <br /> �i�>F*x*�4x*xi�x�F is ix�E icxirxic�c is*rc�Fxxrc is rc�c is is is is is�k is vc is�'cx�e it*�c is is rc�c 9c is it�F is is 7c is is irxxic icn�C)C iC it is it*�c is*ic*ic�cxic icxic ix is it is <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA II CHECK OFF LIST.- Proofread report? Correct LAND USE#? <br /> EH 06 06 Rev 1/99 Correct CONDITION(S)? __V_Logged in LAND USE BOOK? <br />