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NOTE: PULL ALL PERF S (SEPTIC, WELL, ETC...) 1, E COPIES FOR FILE <br /> . LAND USE REPORT APP# )--14 <br /> EIiD RECEIVED APP.REFERRAL: ` 1 0 COMPLETE & SUBMIT BY C A p -, <br /> DATE <br /> ATTN: �r��� <br /> SITE ADDRESS: "lIn 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 /> a <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> Supervisor/Lead Senior Comments: <br /> E� <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> e 17,q�7 CHECx OFF LIST °Proofread report? Correct LAND USE#? <br /> E�06 06 Rev ll9s Correct CONDITIONO 9 - Lngged in LAND USE BOOK? Y . <br />