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P.�r <br /> 4- fru <br /> } N�� <br /> NOTE: PULL ALL PERN4.�.� (SEPTIC, WELL 9 ETC... E COPIES FOR FILE� <br /> LAND USE REPORT APP# S/9 Y31 <br /> EHD RECEIVED APP,REFERRAL: 1 -r COMPLETE & SUBMIT B —� <br /> DATE <br /> DATE <br /> ATTN: n n <br /> SITE ADDRESS: ' <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 /> 4 showing population density, location of house,wind direction, etc.... <br /> s Public water: Public sewage: <br /> 7 <br /> SUMMARY OR COMMENTS: <br /> _ p <br /> f <br /> I recommend: Approval Denial Continuance Inspector's S nate <br /> :t <br /> Supervisor/Lead Senior Comments: <br /> �: w -u�c <br /> '� ' �a� - ► <br /> a <br /> u <br /> C. <br /> SUPERVISOR/LEAD SENIOR APPROVAL: - <br /> . <br /> c t ::-Proofread re art? Correct LAND tGS�#9K <br /> OA I�CEGIC OFF LIST <br /> � � `:Correct CONhITI01V(S)'` Logged in LAND IISE B(10K7 <br /> Eli 06 06 Rev 1199 <br />