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{ . } NOTE: PULL ALL PERMITS (SEPTIC, WELL, ETC...) N KE COPIES FOR FILE <br /> F <br /> LAND USE REPORT APP# L - / <br /> EHD RECEIVED APP.REFERRAL: -7- 31 -06 COMPLETE & SUBMIT BY P61 �& <br /> -&-6 <br /> DATE DATE <br /> ATTN: <br /> SITE ADDRESS: , <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 C MMENTS: <br /> C 01 <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> Supervisor/Lead Senior Comments: <br /> lo ' lJ <br /> SUPERVISORILEAD SENIOR APPROVAL: <br /> . id- <br /> OA IICHECK QFC LISTS Prvofrea report? " A Correct LAND USE#9 <br /> EH 06 06 Rev 1199 <br /> � ``Correct C�I�DITION 9 ' � Lo ed in LANl3 ITSE EOOS�� <br />