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+ NOTE: PULL ALL PERMITS (SEPTIC, WELL, ETC...) MAKE COPIES FOR FILE <br /> LAND USE REPORT APP# <br /> EHD RECEIVED APP.REFERRAL: -13-10 COMPLETE & SUBMIT BY �' 9 <br /> DATE DATE <br /> ATTN: J E's hL r <br /> SITE ADDRESS: I /Q no 11)LijC rP c)1, <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 /> CO.,N , 4D�j P <br /> `21 u <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA H CHECK OFF LIST. Proofread report? Correct L.4ND USE#? <br /> EH 06 06 Rev 1/99 Correct CONDITION(S)? Lo <br />