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NOTE: PULL ALL PERIVMS (SEPTIC, WELL, ETC...) IV KE COPIES FOR FILE <br /> LAND USE REPORT APP <br /> EHD RECEIVED APP.REFERRAL: '1 COMPLETE & SUBMIT BY 175 03 <br /> DAT DAT <br /> ATTN: T <br /> A <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: .-9z--0 Public sewage: <br /> SUMMARY OR C ENTS: <br /> IAI <br /> Me— <br /> .7' <br /> I recommend: Approval `" Denial Continuance Inspector's Si atur <br /> �c 9r Sex kart�'exdc 4c 9e�c�'c7c*�c�c�'cnsc*�Fx�c�F ie�c yc�9c is is jcx�c�c�'c�c�c�'c�e�ex�Yx�c*ic is�c is icx�c*9e�e is�e*�c a'e de�e�F�e 9c 9e�c� eicx'c 4ex�c�exye �eic*�'cx <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA II CHECK OFF LIST: Proofread report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged ett LAND USE BOOK? <br /> F.I 106 06 Rcv 1199 --_------ <br />