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� S�b si.*uL, P��s�e6o in <br /> COTE: PULL ALL PERNx,ef S {SEPTIC, WELL, ETC...}�r�-iKE COPIES FOR FIL� <br /> Jr <br /> LAND USE REPORT APP# <br /> EHD RECEIVED APP.REFERRAL: --0I COMPLETE & SUBMIT BY_ � <br /> DATE � DATE <br /> ATTN: a <br /> SITE ADDRESS: Ll <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 /> M RY OR COMMENTS: <br /> oe- <br /> I recommend: Approval Denial Continuance Inspector's Sign e ice. <br /> Supervisor/Lad Senior Comments: <br /> o -- <br /> - e <br /> 2 :C) <br /> 47 <br /> C. l <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> r <br /> r� SOA II ClL� -K-'OFF LIST ProoJrend report? Correct LAND [ISE#9 <br /> � ' :Correct CONDITION(S)7 Logget�in LAND i1SE BODK? <br /> EH 66 06 Rev 1199 <br /> d <br />