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NOTE: PULL ALL PERMS (SEPTIC, WELL, ETC...} <br /> KE COPIES FOR FILE <br /> 4. <br /> LAND USE REPORT APP# <br /> EHD RECEIVED APP.REFERRAL: a LO 0[ COMPLETE & SUBMIT BY <br /> -OL- <br /> DATE <br /> DATE <br /> ATTN: <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 /> showing population density, location of house, wind direction, etc.... <br /> Public water: Public sewage: <br /> SUMMARY OR COMMENTS: , <br /> I recommend: Approval Ae Denial Continuance Inspector's Sig <br /> Supervisor/Lead Senior Comments: <br /> kf <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA II CHECK OFF LIST '¢ e Proofread report? Correcf LAND[ISE#9 <br /> r A. <br /> EH 06 06 Rev 1199 k� �'``� Cortec!CONDITIONS)q�LLagged frt�LAND USE BODK� <br /> k <br />