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NOTE7: PULL ALL PERMITS (SEPTIC, WELL, ETC...) MAKE COPIES FOR FILE <br /> LAND USE REPORT APP# 9� <br /> EHD RECEIVED APP.REFERRAL: —/ COMPLETE & SUBMIT BY <br /> DATE DATE <br /> ATTN• <br /> SITE ADDRESS: a 56 90 IV , T z �i <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 /> (D q, <br /> I recommend: Approval Denial Continuance Inspector's Signature -t---y re d, <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> O.4 II CHECKOFF LIST.- V Proofread report? Correct LAND USE#? <br /> EH 06 06 Rev 1/99 _Correct CONDITION(S)? _,Z Logged in LAND USE BOOK? <br />