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NOTE: PULL ALL PERA^�'S (SEPTIC, WELL, ETC...) ArrnKE COPIES FOR FILE <br /> LAND USE REPORT APP# E/+ <br /> EHD RECEIVED APP.REFERRAL: <br /> 7-11-o3-- COMPLETE & SUBMIT BY 8 6 <br /> DAI E DATE <br /> ATTN: J P. n fl i /Lt-�- J J llc y <br /> SITE ADDRESS: 13 no n1 t t l l c �fOCJ�'c�ci <br /> i <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 hoose, wind direction, etc.... <br /> Public water: Public sewage: <br /> SUMMARY OR COMMENTS: <br /> ✓�J/l' f�� ,�lL�� �c >_' ��l -� ,Cid 4-3"�i S' S� �7��91Lf7� J/t��'- <br /> (/1rp� py <br /> ell <br /> a- Aa r� / <br /> I <br /> arC�a.•} AM 'Z/�Q�•�h c+✓ � f <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> xx*xx�xxx�x�x,�x��xxxxxKxx*KxxxxxxKxx;*xxx**�;�xFxxxxx*xx,�xnx;:;n�x�x*KKKKxxK:�x*xKx�x*x****� <br /> Supervisor/Lead Senior Comments: <br /> ©y <br /> ti a <br /> Lj <br /> 4401i 'l.- CAG-4 f �^-'E.- <br /> .� 4je a ZO`2Q_ <br /> -w,...� '` .� . ;',,' as-�+r► /!, / 15"' <br /> SUPER ISORILEAD SENIOR APPROVAL: <br /> rj,7 CNECK OFF LIST: Proofread report? Correct LAND USE#? <br /> EH 06 06 Rev 1/99 Correa CONDITION(S)? Logged is LAND USE BOOK? <br />