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NOTE: PULL ALL PE (SEPTIC, WELL, ETC...) AKE COPIES FOR FILE <br /> LAND USE REPORT APP# P14 - V3 <br /> EHD RECEIVED APP.REFERRAL--Y COMPLETE & SUBMIT BY &3:fte <br /> —— <br /> DATE �> DATE <br /> ATTN: 7` red SITE ADDRESS: _4 _ _ /V • �� L� „ . re <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 /> I recommend: Approval Denial Continuance Inspector's Signature <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OAII CHECK OFA15T �` Proo read re arty 3 <br /> f p �orrecl LAND[ISE# �; <br /> EH 06 06 Rev 1/99 ��� � � � �arrect CONDITION(S)n Logged to LAND USE BOOKS� w <br />