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s <br /> NOTE: PULL ALL PERMITS (SEPTIC, WELL, ETC...) ZAKE COPIES FOR FILE <br /> LAND USE REPORT APP# <br /> EHD RECEIVED APP.REFERRAL:DA'Z ..3 COMPLETE & SUBMIT BY <br /> DATE <br /> ATTN: KR l Lto <br /> SITEADDRESS: /7 07 ef, C-ag 4 04tyle Pon <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: aia Public sewage: IU/ <br /> —z <br /> SUMMARY OR COMMENTS: <br /> j� <br /> –A4 <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISORILEAD SENIOR APPROVAL: <br /> OA H CHECK OFF LIST: Proofread report? Correct LAND USE#? <br /> EH 06 06 Rev 1199 Correct CONDITION(S)? Logged in LAND USE BOOK? <br />