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NOTE: PULL ALL PERMS (SEPTIC, WELL, ETC...) M-?-'KE COPIES FOR FILE <br /> LAND USE REPORT APP# -514 -q I - <br /> EHD RECEIVED.APP.REFERRAL: COMPLETE & SUBMIT BY '742 /( J-3 <br /> T DAT <br /> DA <br /> ATTN: <br /> U <br /> SITE ADDRESS: 10 <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 /> SUMMARY OR COMMENTS: <br /> alp <br /> I recommend: Approval Denial Continuance Inspector's Signature xK <br /> Supervisor/Lead Senior Comments: If <br /> V 1110111 <br /> �1lX.A��"^T �Qa4/�W' O✓I YCI�.T1J IC/11��7'/li�/'a.CL_..,. f <br /> P % v <br /> Y <br /> Co ` S�- <br /> "'"'CR <br /> SUPERVISORILEAD SENIOR APPROVAL: <br /> 0,411 CHECK OFF L IST. _Proofread report? _Correct LAND USE#? <br /> Correct CONDITION(S)? _Logged in LAND USE BOOK? <br /> EH 0606 Rev 1/99 - <br />