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e <br /> NOTE: PULL ALL PERMITS (SEPTIC, WELL, ETC...} M/ ivKE COPIES FOR FILE Mr <br /> LAND USE REPORT APP# & <br /> EHI)RECEIVED APP.REFERRAL: 021 COMPLETE & SUBMIT BY .� <br /> D `tF <br /> A5 <br /> D E <br /> ATTN: <br /> SITE ADDRESS: 70 t!� <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 /> zJGZy X27 cam' �• � 7 � .�li <br /> • �i42z::: 4-0 s <br /> I recommend: Approvals Denial Continuance Inspector's Signat <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> Oji 11 CHECK OFF LIST <..e 5= - Propfread repod? Garrett LAND'USE#? , <br /> Correct CONDITIONS) Logger!enl.�lND USE&OOR�" <br /> . .. <br /> Ell 06 06 Rev 1199 <br />