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K. 8 <br /> NOTE: PULL ALL PERM FS (SEPTIC, WELL, ETC...) 1V> KE COPIES FOR FILE <br /> LAND USE REPORT APP#19-1 Oa COMPLETE & SUBMIT BY <br /> EHD RECEIVED APP.REFERRAL:DAT DATE <br /> ATTN: I I <br /> 1 <br /> SITE ADDRESS: �I 7 (/� U l E d <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 /> **�cx**4cx is�e is�c�c sc�c�c�c icx�c�e 9c�c�c is�c rc�c*i'c�c�e�c 9c sr is 9c sc�'c�F do is icxic is is icxic�e�c�E�c�e�Y*9c yc 9cx�c 9c�'c�c dcxicx�c is it�e 9c r'c�c�e k�e*sc�c is�c�c�c ak 4c*ai <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> -.0011 <br /> OA II CHECKOFF LIST. Proofread report? Correct LAND USE#? <br /> EH 06 06 Rev I/99 <br /> Correct CONDITION(S)? Logged in LAND USE BOOK? <br />