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LAND USE REPORT APP ' <br /> EHL` RECEIVED APP.REFERRAL: 4&9 COMPLETE & SUBMIT BY <br /> A E D.a <br /> ATTN: Rei X11 d <br /> SITE ADDRESS: `�_ 7 <br /> In completing the Land Use investigation, draw all Public Health factors on the exhibit (i.e.: sewage disposal, <br /> water suppli;s, 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 /> SjQdMARX OR COMMENTS: <br /> 5 —e <br /> v r �'� �y�i(� �,�rf .S �S �'L' ja-t-pb"X4 <br /> r <br /> !G'� <br /> ✓r <br /> &(1 V ,0 <br /> a 72—> <br /> I recommend: Approval Denial Continuance Inspector's Signature ' <br /> ic:c:eir�e:cs<irx9e�kXie�'e�Fiex*ie��Eiaie�e�Y:rcaeicx�e:eitiedesE�eieiex�'e�e�iae�c�e:�skxskxxicx�ir�ex�e:c4eiexieiex�eseieie�tvvxirzeirxickicir�irircYie eirirx�'eiene <br /> Supen-isor/L.ead Senior Comments: <br /> vV <br /> l s�' <br /> LAND USE CHECK OFF LIST: <br /> �id you proofread the report? <br /> SLPERVISORILEAD SENIOR APPROVAL: DID YqU USE THE CORRECT: <br /> and Use#? <br /> _ ondition(s)#? <br /> /Did you log it as completed? <br />