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NOTE: PULL ALL PERNuTS (SEPTIC, WELL, ETC...)IPAKE COPIES FOR FILE <br /> LAND USE REPORT APP# <br /> EHD RECEIVED APP.REFER&AL:JV -I3 -q / COMPLETE & SUBMIT BY J� -/ <br /> DATE DATE <br /> ATTN: <br /> SITE ADDRESS: / 3 9 e <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 wat'dr: Ajf�L .j G S, ,D/Public sewage: LO(j <br /> SUMMARY OR COMMENTS: <br /> v2 <br /> U- Pk--?O� <br /> I recommend: Approval-1-1-0/ Denial Continuance Inspector's Signatur . <br /> *Xxie�k de ie 9e ie�e ee�e ae fit$*ie�F xic�e ix ie ix ie�e�F aR ie�e is�e�'e�'t ie is is iczz>c<>c icx>c is is�cX�F�e>c i�ic ie iexxic is is icxic is is ie xic is is it ie'ie iexic is:F N-ic is is>'ezic:::c <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> 0.4 H CHECK OFF LIST. Proofread report? Correct LAND USE M? <br /> EH 06 06 Rev 1/99 I Correct CONDITION(S)? Lobed in LAND LSE ROOK? <br />