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NOTE: PULL ALL PERM-7'S (SEPTIC, WELL, ETC...) MAKE COPIES FOR FILE <br /> LAND USE REPORT APP# 0 - 0�J '-Ql <br /> rf( Lll) <br /> F.IID RECEIVED APP.REFERRAL: a� COMPLETE & SUBMIT BA P.I;)(' <br /> DAJE EWrE <br /> ATTN: 4�at� C) <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; <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> xxxic ic>'e 3e r:xx�c 9e*x xxxic�e�c�t�e�C1CX�F r'r�exx�F�c�e>c is is�c�c�c it is�e 7cx is iex�'cic:'c�k�'c yc r'c*ie is ie 7e�F r'e iexiex�F�r x�e ie it it x:Fxien>e 3c iexxie rc is iex>cz is <br /> Supervisor/Lead Senior Comments: <br /> C9 = 'S ,/ ✓ .� <br /> A�2�* 0? <br /> SUPERVISORILEAD SENIOR APPROVAL: -� <br /> OA H CHECK OFF LIST. Proofread report? Correct LAND USE#? <br /> EH 06 06 Rev 1199 Correct CONDITION(S)? Logged in LAND USE BOOK? <br />