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NO',i E: PULL ALL PER TS (SEPTIC, WELL, ETC...) _AKE COPIES FOR FILE; <br /> i,Al' D USE REPORT APP# <br /> EHD RECEIVED APP.REFERRAL: -0 COMPLETE & SUBMIT BY y Z 7 V <br /> DATE <br /> tf DATE <br /> Cj <br /> ATTN: 1 r ,. l <br /> SITE ADDRESS: GJ e S ,k <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: i7 <br /> SUMMARY OR COMMENTS: <br /> � _� - C� � 3,. �"t� ��i/- -� 7��->.F �C.�.�f,.�--" ��rs.,s- .mai /Q'� �/.�.r•�i'� [�s� <br /> /c�- 'Y-,fes/f�rr � c- fs4h -ti ��Ci►`' rj.r�.:.: /[�,+�r.;r*`5 � �!-� �f � - <br /> aa, �-s �i rte. ,. �-. �, -, �,.�,,--�-�; ,� ,� r�-��--� � -�- � �► '� <br /> I recommend: Approval Denial Continuance Inspector's Signa u <br /> �C�C JFXJC JCXX�C�CXX�C IC)C]CX�C;c�>C 1CX:C;GXXICX�(XSCXY)C]C]�C JfXXXZC 7C�CX�fXXX�CXXXJC SCXXX]C�CXX]kKX�C%KX:CXYC%X�CX XlC)CX XX]C 1f $c�t 9t�C 7k' <br /> Supervisor/Lead Senior Comments: <br /> , y <br /> �/ o ,0, j/'.. . <br /> ,rte �,s `ccee <br /> as- Ail, <br /> � <br /> 03 <br /> 15 <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> 0a <br /> OA II CHECK OFF LIST. Proofread report? Correct L.4 ND USE#? <br /> EH 06 06 Rev 1/99 Correct CONDITION(S)? Logged in LAND USE BOOK? <br />