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NOTE: PULL ALL PERMIR (SEPTIC, WELL, ETC...) MW E COPIES FOR FILE <br /> LAND USE REPORT APP <br /> EIID RECEIVED APP.REFERRAL: ' — COMPLETE & SUBMIT BY <br /> DATE DATE <br /> ATTN: C. I I P <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, 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 /> �c�'e�9c*�c*9c�e�c�'c�F�k�'c*4cic9c3cx�e*�cic�'e�c�c�c9ci��e�ciciciric�F�r�c�e�4�+e9r�k�F�e�F�e�'e*�c9e9e�'c**�F9cdc�c�e�e�e�c�e*�'e*9e�e�cdc�'e�'e�e�'e9rde9c�e�xn'e*�e�'e�e�c�'c9c <br /> Supervisor/Lead Senior Comments: <br /> (7-Z <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA II CHECK OFF LIST. Proofread report? Correct LAND USE#? <br /> EF106 06 Rev I/99 <br /> Correct CONDITION(S)? Logged in LAND USE BOOK? <br />