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1�wf I E: PULL ALL PERMT S (SEPTIC, WELL, ETC...) 1V EKE COPIES FOR FILE <br /> LAND USE REPORT APP# P0- C6'? -/l yrielq) <br /> TI�ARAY ON VACATION <br /> / <br /> EHD RECEIVED APP.REFERRAL: w-1�01 COMPLETE & SUBMIT BY n - /6 i,oJE. 7/1/02-7/5/02 <br /> DATE DATE <br /> ATTN: <br /> SITE ADDRESS: <br /> In completing the Land Use investigation, draw all Public Health factors on the exhibit (Le.: 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 /> xxxxxzx�c�c'xx�cxx'x icx9c ac**�c is 9c�c 4c�c�c�c a'cx*�c*�cx�c 4c 4c do�c 9c rr 9c 7c�k*�c��'c�Y�c*a"c�*�cx�c 9c 9c�c�cx9cx�'c 4r�49c yc ie�c�e 9c is 4c icxzic is is icxic�"cxzx <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> r <br /> OA li CHECK OFF LIST. Proofread report? Correct LAND USE#? <br /> EH 06 06 Rev 1/99 Correct CONDITION(S)? Logged in LAND USE BOOK? <br />