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NOTE: PULL ALL PERA41:f S (SEPTIC, WELL, ETC...) M a COPIES FOR FILE <br /> LAND USE REPORT APP#: PA-03- <br /> 569 S REG. APP <br /> EHD RECEWED APP.REFERRAL: 2/10/04 COMPLETE & SUBMIT 114Z- 3j-;04 �p <br /> DATE <br /> ATTN: RAY HOO <br /> SITE ADDRESS: 18327 EAST STATE ROUTE 88 HIGHWAY, CLEMENTS <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 a completed map of area <br /> showing population density, location of house, wind direction, etc.... <br /> Public water: Public sewage: i d <br /> SUMMARY OR COMMENTS: <br /> I recommend: Approval Denial Continuance Inspector's Signat ec— <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> EH 06 06 Rev 3/99 <br /> a..'_ '.:..a.. <br />