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NOTE: PULL ALL PER1Ci1TS (SEPTIC, WELL, ETC...)*AKE COPIES FOR FILE <br /> LAND USE REPORT APP# SU-91-12 Rev. <br /> END RECEIVED APP.REFERRAL: ��/— COMPLETE & SUBMIT BY <br /> DATE // DATE <br /> ATTN: `)P � �.Sll e r— <br /> SITE ADDRESS: 10600 N. St. Rt. 99 E. Fron. Rd. <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 /> ' _ _ <br /> S 1dy <br /> I recommend: Approval Denial Continuance Inspector's Signature 42 <br /> Supervisor/Lead Senior Comments: <br /> a � <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA II CHECK OFF LIST. Proofread report? Correct LAND USE#? <br /> EH o6 ae Rev 1/99 Correct CONDITION(S)? _Logged in LAND USE BOOK? <br />