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NOTC: PULL ALL PERN111S (SEPTIC, WELL, ETC...) AKE COPIES FOR FILE <br /> LAND USE REPORT APP# <br /> EHD RECEIVED APP.REFERRAL: lX COMPLETE & SUBMIT BY <br /> DA E `` DATE <br /> ATTN: \� l\ k NC) mo\ <br /> SITE ADDRESS: Q . Cc"(-(A <br /> J <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 /> altt-a <br /> �?•a 3 <br /> ceY <br /> zr <br /> I recommend: Approval Denial Continuance Inspector's Signature f <br /> �cirFic�cicicFrrxrc9c*icix3c�c�eic�c*fie �c�c�c9eF*"c�cY*�cF*ir�rxa4ixiaic�cF***i"c�c9r�c9c*Ficiriricicixicxiaic*'c�c'car*�c'cic�c�e�r9r4c*�eicx4ieic3c9rFic <br /> Supervisor/Lead Senior Comments: <br /> 0 l- <br /> IT�l�9 <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA II CHECK OFF LIST: Proofread report? Correct LAND USE#? <br /> EH 06 06 Rev 1/99 Correct CONDITION(S)? Logged in LAND USE BOOK? <br />