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r. 41 <br /> ' RB <br /> NOTE: PULL ALL PERMII'S (SEPTIC, WELL, ETC...) MAi& COPIES FOR FILE <br /> PA-0500367 (GP) - SU0005181 & <br /> LAND USE REPORT APP#: PA-0500368 (ZR) - SU0005182 <br /> EIID RECEIVED APP.REFERRAL: 07/06/05 COMPLETE & SUBMIT BY: 07/15/05 <br /> DATE DATE <br /> ATTN: RICK GRIJEFIN <br /> SITE ADDRESS: 12203 N. STATE ROUTE 99 (W. FRONTAGE ROAD, LOD) <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 /> r <br /> S 7 <br /> I recommend: Approval Denial VW Continuance Inspector's Signature <br /> ! Supervisor/Lead Senior Comments: <br /> u.r( <br /> Cry Z <br /> SUPERVISORILEAD SENIOR APPROVAI(,���...�...�AllffifflTS;,-tI-OEH 06 06 Rev 1/99 � `��` ` � 17 <br />