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NOTE: PULL ALL PE rS (SEPTIC, WELL, ETC...)aKE COPIES FOR FILE <br /> LAND USE ]REPORT APP# PA- -.0,- <br /> EHD RECEIVED APP.REFERRAL: COMPLETE & SUBMIT B'Y." .��*� ` �T 2-1 <br /> D E DATE <br /> ATTN: l� <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 O`R_ COMMENTS: <br /> W)nZ Ur <br /> y y..-�-� <br /> -- <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> ***-Ic**********lk 9c&kx9e e'tx4e xC*******X******x9r$cx�e�k c 9r�'t aFx9c ds�c k k�c'c do�c is k isxic is$c kdc:k aF is*ic it ac 'c�cx�ic okxic dsnic c do 9cK <br /> Supervisor/Lead Senior Comments: <br /> AL <br /> 4 <br /> AW <br /> w <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA II CHECKQFFLIST� Praofrettd reports Correct`LA11rD USEV. <br /> EH 06 06 Rev 1/99 nrreCt GOIVDI77011�(SJ Logged rn.LAND US`EBOOK?- <br />