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ly Q <br /> NOTE: PULL ALL PER 'TS (SEPTIC, WELL, ETC...) AKE COPIES FOR FILE <br /> `LAND USE REPORT �-' APP# <br /> AEHp RECEIVED APP.REFERRAL: �I�`r 0� COMPLETE & SUBMIT B <br /> DATE DATE <br /> ATTN: <br /> SITE ADDRESS: <br /> In completing the Land Use investigation, draw all Public Health factors on the exhibit (i.e.: sewage disposal, <br /> water supplies, ete...). 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 Si A <br /> oFir�r$e:'reek$e�'rxxx:�r:F�F�kir:kirele�ciea'c�rir3rirknFk�edc8r9taYia�r*de*Jrir�eir�e�edr9edeie�eie�cJrieirxirir:+r3ek�cieaFaE �e9rsr�r $e de�'evk:kde�F9exie�c:k�ek:F <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISORLEAD SENIOR APPROVAL: <br /> 0�4'II CUECK OFF LIST ' Proofread repart?x Correct LAND,U.SE`#9 <br /> Eli 06 06 Rev 1/99 Gorreet CONDITIO}1'(S)� '- f Logged ire LAND USEBOOKa'. E. <br />