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s <br /> NOTE: PULL ALL PERMIT S (SEPTIC, WELL, ETC...) M2 KE COPIES FOR FILE <br /> LAND USE REPORT APP# <br /> EHD RECEIVED Arr.REFERRAL:~ "dQ COMPLETE& SUBMIT BY ./4, -� <br /> DATE DATE <br /> ATTN.- tS <br /> SITE ADDRESS: s AL- <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 /> I SUMMARY OR COMMENTS: <br /> % - <br /> ZZ . a 3 <br /> I recommend: Approval Denial Continuance Inspector's Signature����L <br /> Supervisor ead Senior Com en s. <br /> f <br /> -6017 <br /> /00 <br /> SUPERVISORILEAD SENIOR APPROVAL: <br /> DA'1X CFIEGK aFF ST 4W Jor <br /> -d—report? ' Correa L:9ND,DISE#9 <br /> EH o5 ob Rev trsg C0NDITION(S}�2 � Logged in LANb iISEBOf?R7 <br />