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N JTE: PDLL ALL PERM!'- (SEPTIC, WELL, ETC:..) M 'iCE COPIES FOR FILE <br /> r <br /> LAND USE REPORT APP# <br /> EHD RECEIVED APP.REFERRAL- r 0 COMPLETE & SUBMIT BY <br /> DATE DATE <br /> AT TN: a �l'7oD C. d. LLA,, , <br /> SITE ADDRESS: _� ` ---- �;�r)/'er1 _' <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 sewage: <br /> Public water:' <br /> SUMMARY OR COMMENTS: <br /> 1 <br /> r <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> SQA 1I CHECLAND USE#r <br /> EH ob ob Rev ins �� GcitTect CONDITIQiIF{SjX' Lo`$ed LAND USE <br /> i3 <br /> �•¢.,�i;.,. ..�e��.,n �.�{.. ;�s z .i;. ^,"�•s�,,: � 3���:.sax !-,irk, »3 s"a., � -a.as.�.' . z.-!i 'li� <br />