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NOTE: PULL ALL PERM YfS (SEPTIC, WELL, ETC...) 1*EKE COPIES FOR FILE <br /> LAND USE REPORT APP# 7 -r of s L2 <br /> EHD RECEIVED APP.REFERRAL:�1 —_�—d I COMPLETE & SUBMIT BY I ' o2 V <br /> DTE DATE <br /> ATTN• c7 p-* <br /> SITE ADDRESS: <br /> In completing the Land Use investigation, draw all Public ealth factors on the exhibit(i.e.: se ge 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 /> ./Vo NEuw AT- <br /> I <br /> TI recommend: Approval Denial Continuance Inspector's Signature <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISOR/LEAD SENIOR APPROVAL: -� <br /> OA/I CHECK <br /> OFFLIST., Proofread report? _Correct LAND USE V <br /> EH 06 06 Rev 1199 Correct CONDITION(S)? Logged in LAND USE BOOK? <br />