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NOTE: PULL ALL PERMITS (SEPTIC, WELL, ETC...) IvAKE COPIES FOR FILE <br /> LAND USE REPORT APP# <br /> EHD RECEIVED APP.REFERRAL: COMPLETE & SUBMIT BY <br /> DATE / ATE <br /> ATTN: L pct e)e- <br /> SITE ADDRESS: 1J <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 /> V. <br /> V 49 <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> �Fxicicxxxi��cxxx�c�c:Fir:F�`cx�cxx>cxic:Firxic�F4cisxxirx>'ricx�cxxir*xic�'cic�cicic kicxic>'rxxiricxisicxxiricxxicx kxxicxirxicxz:Fxiricirx:Fxic <br /> Supervisor/Lead Senior Comments: <br /> �U <br /> :0 S" <br /> Cx/tQ.cz <br /> 1,2 <br /> v <br /> SUPERVISORILEAD SENIOR APPROVAL: 70 <br /> OA II CHECK OFF LIST: 73- <br /> Proofread report? Coned L.4fV USE#? <br /> t oh oh Re (l7 - Correct CONDITION(S)? Logged in LAND USE BOOK? <br /> - - <br />