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J / <br /> NOTE: PULL ALL PERMITS (SEPTIC, WELL, ETC...) MAKE COPIES FOR FILE <br /> LAND USE "PORT /�/� APP# 51q - 99 - `/S <br /> EHD RECEIVED.APP.REFERRAL: VJ--7 . qq COMPLETE & SUBMIT BY- 7 - 6 - 99 <br /> DATEII-- DATE <br /> ATTN: �I P � 15,<,/i E. 1' <br /> SITE ADDRESS: a 0 of 7 5 S f4,A ,/e e d Tr o C.0 <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 /> X11,, ani0Ahkals 47�46,E <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA II CHECX O f"IST Proofread repo Correct LAND USE#? <br /> EH 06 06 Rev u99 V Correct CONDMON(S)f Logged in LAND USE BOOK? <br />