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NOTE: PULL ALL PERMITS (SEPTIC, WELL, ETC...) MXKE COPIES FOR FILE <br /> LAND USE REPORT APP# <br /> MID RECEIVED APP.REFERRAL: U' 'CJS COMPLETE & SUBMIT BY <br /> DATE DATE <br /> ATTN: fq�1 <br /> SITE ADDRESS: 6 y �G1 ��✓ <br /> In completing the Land Use investigation, draw all Public Health factors on the exhibit G.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: U& Public sewage: <br /> SUMMARY OR COMMENTS: <br /> o'25 t�--xF� <br /> 11 b,64JyyL � his s rs rsw -S <br /> �La-0 SANr)I o(L' ,;e5-f"(Zitrwz <br /> la- v <br /> Ian V. <br /> J <br /> r <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> xde�k�ex�c* F ic>c�'c�k is*�F*'cyc*9c�Y�Fkx>cF>k�exxir is F is scxicx**�c it*x�Y�r*9c*x*�c�c*t>c�c F is k'c*�c 9c�'c**�c 'c* F 9c 9c 9c*9c�e *�Fxxirz�c�c�c*fir�F <br /> Supervisor/Lead Senior Comments: <br /> c;o- <br /> 11 <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA II CHECK OFF LIST. Proofread report? Correct LAND USE#? <br /> Eli 06 06 Rev 1/99 Correct CONDITION(S)? Logged in LAND USE BOOK? <br />