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♦ , <br /> NOTE: PULL ALL PERMITS (SEPTIC, WELL, ETC—) AKE COPIES FOR FILE <br /> LAND USE REPORT APP# 6 , - --�,, G <br /> EHD RECEIVED APP.REFERRAL:-7 --3J _00 COMPLETE & SUBMIT BY !) y ! y Q <br /> DATE DATE <br /> ATTN: Jen n i J ©/'C: / <br /> SITE ADDRESS: 75 3 0 -S� <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 /> /! ll. to sliR �E�sua suQ� <br /> r/ �6PT� � <br /> -2 r T-P,ffn-e- e P <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> ate�c*�c�c�c�c�E sir*�c�c 9e 9c*�c*fie 9c�c 9c is�c*dc 9c�c 4c 9c 3c�e 9e�r 3e 9c 9r�r*�c 9e 9r sir�c�k 9c 9c�'c9c*ic�E�c do*�c 9c vY 9c is�c�c is is is�Y 9c do 9c 9c ie 9cxxx9c do 4c�c*�c�c�F is ic is�c ie�c�Fx <br /> Supervisor/Lead Senior Comments: <br /> t� 7 <br /> -0 :1z� <br /> d 3 aaQ-�• r �- <br /> � a2 : DI <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA H CHECK OFFLIST. Proofread report?' Correct LAND USE#? <br /> EH 06 06 Rev 1/99 Correct CONDITION(S)? Logged in LAND USE BOOK? <br />