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N=)TE* PULL ALL PERMI'_. (SEPTIC, WELL, ETC-) M). ; COPIES FOR FILE <br /> LAND USE REPORT APP#�5' ,Q _ F9 -A) y <br /> EHD RECEIVED APP.REFERRAL: 1 - /0 -00 COMPLETE & SUBMIT BY - / -O o <br /> DATE DATE <br /> ATTN: J S J-V- r <br /> SITE ADDRESS: 1778 <5 li Leo eU a i F S <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: N� Public sewage: <br /> SUMMARY OR COMMENTS: <br /> x7 <br /> I recommend: Approval Denial Continuance Inspector's Signature �c <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA!/CHECKOFF/�FIST: Proofread report? Correct LAND USE#? <br /> EH 06 06 Rev 1/99 a (; rrect CONDITION(S)? Logged in LAND USE BOOK? <br />