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L ' APP#_ L / 9 -a <br /> LAND USE REPORT - <br /> �?�27 COMPLETE & SUBMIT BY � S � 1 9 q <br /> EHD RFCEIX'ED APP.REFERRAL: <br /> DA DATE <br /> ATTN: <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: f- Ca. 'k I 4ZArF_ <br /> Public sewage: a)s-,At <br /> SUMMARY OR COMMENTS: <br /> !6, Aw.-wowsento <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> irxie ie�k it it it kie it is it it is ie irtdr��k kir ak it:kir*9r�k��k ie irxie aF it ie it it it vk*ic is it it r.Ftxeir ak�Ir�k:kxie it it it ie is ie:«�r�kxie ie ie ie it�r�k it it it ie ie is is ie is:k it tc it it <br /> Supervisor/Lead Senior Comments: <br /> LAND USE CHECK OFF LIST: <br /> Did you proofread the report? <br /> SUPERVISOR/LEAD SENIOR APPROVAL: DID YOU USE THE CORRECT: <br /> Land Use#? <br /> _Condition(s)I!? <br /> Did you log it as completed? <br />