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NOTE: PULL ALL PERMITS (SEPTIC, WELL, ETC...) -LAKE COPIES FOR FILE I� <br /> LAND USE REPORT APPA <br /> EHD RECEIVED APP.REFERRAL._-�I 9 COMPLETE & SUBMIT BY f `15e qeU�P Yllj <br /> DATE DATE <br /> ATTN: -rI r'1 Gt O,k it m P i. <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, Iocation of house, wind direction, etc.... <br /> Public water: aPS Public sewage: e!5 <br /> SUMMARY OR COMMENTS: <br /> A <br /> I recommend: Approval Denial Continuance Inspector's Signatur <br /> ***de�e is ae.4�e ie�c**vc**:E F*****sir*�e:E**�k*ie�e*:k*fie Te*:F'c it ie ie aY�r ek 4ele*Y It is 4e*!e*de�t k*it�e c$e k9c 7k ie do*fie*hvF*�r*vc*'e**'s**�c*** <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA II CHECK.,OFF LIST. Proofread repoiV. Correct LAND USE#71" <br /> 06 06 rev i»g Correct COIVDITTON(s)? Logged in•L.4ND USE BOOR?' <br />