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/eJ <br /> NOTE: PULL ALL PERI- _TS (SEPTIC, WELL, ETC...) -,,AKE COPIES FOR FILE <br /> LAND USE REPORT APP# 2L <br /> EHD RECEIVED APP.REFERRAL: I& COMPLETE & SUBMIT B ' 1 <br /> DA —— <br /> ATTN <br /> SITE ADDRESS: t <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 OR COMMENTS: <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> 7c�k*ir aF icx�k�F icxx>cx�c sc�"cxic�CXXX%XXXX%X*�c>'cxac xir it�F>c is is�c icxic is is is icxicxjrkic is�c is icxic iczx�c is irxicx>cxic>'c is�c*sc�Fxxxicxic irxxic <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA II CHECK OFF LIST. Proofread report? Correct L,4ND USE#? <br /> EH 06 06 Rev 1/99 Correct CONDITION(S)? Logged in LAND USE BOOK? <br />