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NOTE, PULL ALL PERNMS (SEPTIC, WELL, ETC...) M7(KE COPIES FOR FILE <br /> LAND USE REPORT 7 UU APP# <br /> EHD RECEIVED APP.REFERRAL: B Oz COMPLETE & SUBMIT BY /1 /nA 7— <br /> DATE DAT <br /> ATTN: L ect r1 n (\1�J¢. H Q <br /> SITE ADDRESS: <br /> In completing the Land Use investigation, draw al 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 /> *��nxx�**�x,�*xx:�xx;**xx*xKxx:��xxxxx******x,�xxxx:�*x*x****xxxxxxxxx*x*Fx**xxx***x*xKxKKx:�x�F <br /> Supervisor/Lead Senior Comments: <br /> i2 <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA H CHECK OFF LIST: Proofread report? Correct LAND USE#? <br /> EH 06 06 Rev 1/99 Correct CONDITION(S)? Logged in LAND USE BOOK? <br />