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NOTE:' PULL ALL PER,,..,ITS (SEPTIC, WELL, ETC...) `AKE COPIES FOR FILE <br /> LAND USE REPORT <br /> EHD RECEIVED APP.REFERRAL: � "���� COMPLETE & SUBMIT BY A�qAP.P ' �. <br /> DATE yDA7 E r�Y <br /> ATTN: (VA V IIJIA,&Ce <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 /> �c�cdcx�r�kek��esirxicka�c:h3r�r�k�'c�ee+e�'e9c!caF�Fk�c*irde��'r�ex9:�rKntdcaE�kk�fric�k�cxicsfexx�cickdricde3el:$c�'c�c$ckaE�F�E*�eir9clr�FJreFx�exx�cxvcdcdrie�kx�'coir <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA II CITE&6iF'LIST <br /> EH 06 06 Rev 1/99q ENTERED IN LAND USE LOG ✓ <br /> CorrectDAR <br /> rP- DEAD ON CAI, <br /> w <br /> I <br />