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NOTE: PULL ALL PERMITS (SEPTIC, WELL, ETC...) NrAKE COPIES FOR FILE <br /> LAND USE REPORT APP ( I P h-- <br /> EHD RECEIVED APP.REFERRAL: COMPLETE & SUBMIT BY /(// -7/03 <br /> DAT TDATE <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 Denial Continuance Inspector's Signature <br /> *�Fac**�F**�rdc*�Fdeic�F�r9e�c�c�e�'etc*aF�Fdcie*9c�c9c�'ck9c�4�k�k�c*�'c�c�e�'e�eie**�cvkicicic�Fdr�e�eieie�e*�exicieX�c�'c9e�F9e9e�'etc*9c�F�Fde�F�eicieicieic�c�cicxic <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA Il CHECK OFF LIST. Proofread report? Correct LAND USE#? <br /> Ell 06 06 Rev 1/99 Correct CONDITION(S)? Logged in LAND USE BOOK? <br />