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SSci`P�- JX <br /> NOTE: PULL ALL PES (SEPTIC, WELL, ETC...) MAKE COPIES FOR FILE <br /> LAND USE REPORT APP# 14,S -OCA-%,/ <br /> EHD RECEIVED APP.REFERRAL:�� a�V"U� COMPLETE & SUBMIT BY -7 -,5 -00 <br /> DATE DATE <br /> ATTN: _ LkVjiv,c11 41- C' h/1 77 <br /> SITE ADDRESS: �2 51 y 5- <br /> In <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 /> C' <br /> fU:U� /�uJ3c�iC 5'�wEft <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> �c�c�c�c�Fic�cdc*�F�ca'c�eie9c*oE�cX�F�c9c�4�cie***�c�e�c�F9cic***ic�F�c�F�Fx�cic�F�c�c�c*9c�k�4ir�c9c�c�"c�cic9ci�icicicicieiricic�c�c�c�c*9c�cic�c9c�F�cicicicicxiricx <br /> Supervisor/Lead Senior Comments: <br /> Ca <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 />