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LAND USE REPORT APPA <br /> EHD RECEIVED APP.REFERRAL: COMPLETE & SUBMIT BY �" 7 <br /> DAT DATE <br /> ATTN: <br /> SITE ADDRESS: 010 <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 /> 00 <br /> I recommend: Approval—LZ Denial Continuance Inspector's Signature <br /> 'k <br /> Supervisor/Lead Senior Comments: <br /> LAA'D USE CHECK OFF LIST: <br /> t/Did you proofread the report? <br /> SUPERVISOR/LEAD SENIOR APPROVAL: DDD YOU USE THE CORRECT: <br /> jand Use k? <br /> ondition(s)#? <br /> Did you log it as completed? <br />