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` RB <br /> NOTE: PULL ALL PERMITS (SEPTIC, WELL, ETC...) MAKE COPIES FOR FILE <br /> LAND USE REPORT APP#: PA-04-203 (ZR), PA-04-2Q (�& PA-04-225 (TA) <br /> EHD RECEIVED APP.REFERRAL: 5/10/04 COMPLETE & SUBMIT BY: 5/31/04 <br /> DATE DATE <br /> ATTN: JENNIFER JOLLEY <br /> SITE ADDRESS: ZR & GP -11396 ST. RT. 99 E. FRONTAGE ROAD TA=C0UNTYW11DE <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 a 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 /> SUPERVISORILEAD SENIOR APPROVAL: <br /> SH 06 06 Rev 1/99 OA H CHECK OFF LIST.• Proofread report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE BOOK? <br />