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rn <br /> NOTE: PULL ALL PERMITS (SEPTIC, WELL, ETC...) 1Vi-A�E COPIES FOR FILE <br /> LAND USE REPORT APP# _ L <br /> EHD RECEIVED APP.REFERRAL: 1 0 C1_ <br /> OMPLETE & SUBMIT BY a any <br /> D TE DATE <br /> ATTN: � — � <br /> SITE ADDRESS: \ r V <br /> In completing the Land Use investigation, draw all Pub �th 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 /> 9 <br /> I recommend: Approval Denial Continuance Inspector's Sign to <br /> Supervisor/Lead Senior Comments: <br /> ip C111 <br /> SUPERVISORILEAD SENIOR APPROVAL: <br /> OA II CHECK OFF LIST Prvoiead report? Correct LAND(ISE#9 <br /> LaCorreet COti <br /> NDITION{S) <br /> ed to LAND <br /> E1106 06USE BOOR y G <br /> Rcv 1199 <br />