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J- LAND USE REPORT APP# L r4 - R l - ,3 <br /> F HD RECEIVED APP.REFERRAL: jqqq COMPLETE & SUBMIT BY A,5 /I � <br /> DATE DATE <br /> ATTN: S" <br /> SITE ADDRESS: a 2 rkl-1 n9,,,, L= <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 /> 01210 /S Ie A,�r' 011af <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> i'e ve ie�<xis is is ic��e is it it�;it�i�vF is is ie�r ie�e ie dek�;$x�'t iex�r ze Lexi:�rxie�e de dcx�fr ie iex�ex�4��c ocxx:c:E ie is dcxr�e vF of aF 4e$xicxis eY�'e 9r ie�c�c do iex kir eF�F x�'t <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br />