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RT <br /> NOTE: PULL ALL PERNirfS (SEPTIC, WELL, ETC...) M-i<KE COPIES FOR FILE <br /> LAND USE REPORT APP#: PA-04-82 LA <br /> Ei RECEIVED APP.REFERRAL: COMPLETE & SUBMIT BY:*A YAP- 5 04 <br /> DATE <br /> DATE <br /> ATTN: <br /> SITE ADDRESS: 15586 SOUTH SEXTON ROAD ESC ON <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 a completed map of area <br /> showing population density, Iocation of house, wind direction, etc.... <br /> Public water: Public sewage: <br /> SUMMARY OR COMMENTS: <br /> I recommend: Approval Denial Continuance Inspector's Signatur <br /> Supervisor/Lead Senior Comments: <br /> os <br /> SUPERVISORILEAD SENIOR APPROVAL: <br /> EH 0606 Rev 1/99 0 � Tttft dpfD�Fi°Ci '�l` . <br />