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r <br /> �r %Now <br /> OTE: PULL ALL PERMITS (SEPTIC, WELL, ETC...) MAKE COPIES FOR FILE <br /> LAND USE REPORT APP# a R01 - 11 <br /> EHD RECEIVED APP.REFERRAL: —I—( —q COMPLETE & SUBMIT BY / <br /> DATE DATE <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: lye 17 c, Public sewage: <br /> SUMMARY R COMMENTS: <br /> -Ply/ <br /> / �,gb oz. <br /> //-67 ion 5, o 2- <br /> .6e P <br /> 6eP All P //'65r <br /> y) t/- OZ .►e�o�, , EX,gliinh x�Dn lro�it�/:d,o�y) �P,��'� ��/ ��Y� <br /> o <br /> r� Fx �St,��A 1w1EZC io he - 0sO -d f6-< Del-rtr-Arm,111.-A - ZF-6l,)4mf074 fps arc -(0(401 <br /> -Ilse well -,halt �ec 5q, r ` (ciz �ANtll -j:,z- odd s tIe,,J Weft 1-6jJ�/Ie �f 5-Vyt�( rhe --,rJPd 16t7�PG��; �z <br /> '7) -64 <br /> (D 5) L AID/tea ioz�es <br /> I recommend: Approval Denial ` Continuance Inspector's Signatur�-�:,,�,i&e Z�1 <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISORILEAD SENIOR APPROVAL: <br /> OA II CHECK OFF LIST. L Proofread report? ---4,-Correct LAND USE#? <br /> EH 06 06 Rev 1/99 Correct CONDITION(S)? Logged in LAND USE BOOK? <br />