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NOTE: PULL ALL PERMITS (SEPTIC, WELL, ETC...) MAKE COPIES FOR FILE <br /> LAND USE REPORT APP# Ll� - q9 -6 o <br /> EHD RECEIVED APP.REFERRAL: I o-13"%! COMPLETE & SUBMIT BY )1 .541 ra-moo -99 <br /> DATE DATE <br /> ATTN: e <br /> SITE ADDRESS: I1 6 L2 /0Cotc ad L"'.1 <br /> 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: 6bVIL Public sewage: <br /> SUMMARY OR COMMENTS: <br /> �. - <br /> I recommend: Approval `� Denial Continuance Inspector's Signature 'jggn- fl gK� <br /> ******ir*ir**�a*xak:F�c�eaF*1r�4*�Fic�F�Y�ex*h�e�e�itieiticic*icic�k*�c*de**�raktFie:F�YIe*3r do*�eic ie�'e4e�e�r�'cie�c�Eir*9c�cie�eit9s*�te9cairde�e�citic*�Ek <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA H CHECKOFF LIST.- Proofread-report? Correct LAND.USE#? <br /> Eli 06 06 Rev 1/99 Correct CONDITIONS)?. Logged in LAND USE BOOK? <br />