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NOTE: PULL ALL PERMITS (SEPTIC, WELL, ETC...) Nf? KE COPIES FOR FILE <br /> LAND USE REPORT <br /> I� APP# 5/,0, <br /> IU V �s v <br /> EHD RECEIVED.SPP.REFERRAL: � I—� '0/9 COMPLETE & SUBMIT BY — iM <br /> q DATE <br /> DATE <br /> ATTN: <br /> Cam_ l–v in r-^ a <br /> SITE ADDRESS: c <br /> Cjr� <br /> is <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 <br /> ewage:SUMMARY OR COMMENTS• <br /> ii <br /> I <br /> ,I I� <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> :49t***Y*�**Jr*****ie1e*:F*9c***�edek**k**�r$r*�e�e****iencir�e�le****�r**at****ieirir�t**ie*de**Ys'evt**frcxTex�e*'s*Yeie*aks4:F <br /> !I <br /> Supervisbr/Lead Senior Comments: <br /> H v <br /> I� <br /> II <br /> I' <br /> , t <br /> vs <br /> I�. <br /> SUPERVISOR/LEAD SENIOR APPROVAL:fio, <br /> i; <br /> DA IT CHECK OFF LIST: Proofread report? Correct LAND USE'#? ' <br /> Eli 06 06.Rev 1199 Correct CONDITIOrY(S)?' Logged in LAND USE BOOK? <br />