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• LC� <br /> NOTE: PULL ALL PERM--i'S (SEPTIC, WELL, ETC...) Nrr<KE COPIES FOR/ FILE <br /> LAND USE REPORT APP# <br /> EHD RECEIVED APP.REFERRAL: ! V �I—O Y I (> /U' - 0 a <br /> DATE ")ATE <br /> ATTN: � C1 n C_ Q t` <br /> SITE ADDRESS: 7 g ,`i C �i., 1�Ll _S C�ifL/v— <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 /> 17 <br /> 12 <br /> I recommend: Approval /Y Denial Continuance Inspector's Sig, .fes <br /> ***,•.*��,+*,.r ,�x;.n�,�,���x��;�x�**�x,�xx;.K****x�*���*x,�x:*xx******�**,�:�***����:��** *****xx�a��**x <br /> Supervisor[Lead Senior Comments: <br /> SUPERVISORILEAD SENIOR APPROVAL: <br /> OA H CHECK OFF LIST: Proofread report? Correct LAND USE#? <br /> Elf 06 06 Rev U99 Correct CONDITION(S)? Logged in LAND USE BOOK? <br />