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NQ TE: PULL ALL PERM,'S (SEPTIC, WELL, ETC...) I''.,,-KE COPIES FOR FILE S-I <br /> ` <br /> LAND USE REPORT APP# <br /> EIID RECEIVED APP.REFERRAL: �� P/ COMPLETE & SUBMIT BYDATE •s U14Z <br /> DA <br /> ATTN: Llan& "U ollyr <br /> SITE ADDRESS: 3b/2 r tc)a4e,-1w ` &c 411h <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 <br /> RC-NovE �hL� T)o� ��/E 5 o�vPE J4 wctK <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> Supervisor/Lead Senior Comments: <br /> oy <br /> lo - " <br /> (3 /o • ay <br /> C ;�-o osS <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA H CHECK Off'LIST: Proofread report? Correct LAND USE#? <br /> rH 06 06 Rev 1/99 <br /> r Correct CONDITION(S)? Logged in LAND USE BOOK? <br />