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+ NOTE: PULL ALL PERMITS (SEPTIC, WELL, ETC...) MAKE COPIES FOR FILE <br /> LAND USE REPORT APP# 0]5 -qq - k <br /> EHD RECEIVED APP.REFERRAL: (�I —q COMPLETE & SUBMIT BY L`1 I 9 1 — 6 <br /> DATE DATE <br /> ATTN: JLL S r <br /> SITE ADDRESS: .�j(7 R F'. A ., .-'cam ton <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 /> CC 0 4 <br /> 02- � k - d? <br /> L-) WOG Ao P C& 3 <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> oFX�F:4�F sir 9c�e�e$�r�e*air�r�'t�Ft**ie�e�e�'t�k�'e de�e*9e 9exie:cxx:c iex Xxix is icx Yicx�'r<icx�ic is*icx:c is is icxicxic is is�F is�Fxic:kxrc is is is is:s:c>i+:r it is icxic is <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA II CHECK OF LIST.• Proofread reportr' 1 Correct LA VD USE#? <br /> EH 06 06 Rev 1/99 ✓/ Correct CON ITIONS)? V Logged in LAND USE BOOK? <br />