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NOTE: PULL ALL PERMITS (SEPTIC, WELL, ETC...) NrtKE COPIES FOR FILE <br /> LAND USE REPORT APP# <br /> EHD RECEIVED APP.REFERRAL. J/j COMPLETE & SUBMIT BY <br /> DA E AT <br /> ATTN: O Q. y� �ti✓� <br /> SITE ADDRESS: <br /> In completing the Land Use investigation, draw all ublic 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: /L/ Public sewage: IL-1111 <br /> SUMMARY OR COMMENTS: <br /> ll <br /> b - S Al/ . <br /> 01 <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> xic iic xic iic k it is�'cxxF*xi'cxic�c**�c Fxic�cxzxxxxicxxx�'cxx�c>c�c icx is*iczx�cxicxxxxxxzx x:i icxxic is xic iczic,icxsc icxicxx>c icx icxic is is <br /> Supervisor/Lead Senior Comments: <br /> 0 <br /> � v <br /> � T <br /> Le� <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA II CHECK OFF LIST: Proofread report? Correct LAND USE#? <br /> Ell 06 06 Rev 1/99 Correct CO,tiDITIOY(S)? Logged in LAND USE BOOK? <br />