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t- <br /> NOTE: PULL ALL PERM 'rS (SEPTIC, WELL, ETC...) lb�l-,eKE COPIES FOR FILE <br /> 0 <br /> ii <br /> LAND USE REPORT APP# <br /> EHD RECEIVED APP.REFERRAL: tO 6 COMPLETE & SUBMIT BY s <br /> II DA E <br /> ATTN• 15�U( all) <br /> SITE ADDRESS: d �he <br /> � <br /> In completing the Land Use investigation, draw all Public Health factors on exhibit (i.e.: sewage disposal, <br /> water supplies, etc...).I�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: I1 Public sewage: <br /> ;o <br /> SUMMARY OR COMMENTS: <br /> I! <br /> li <br /> I <br /> M <br /> I� <br /> 1� <br /> I <br /> i� <br /> I <br /> I� <br /> i <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> �coF9r�ede4de��eleXi-1eF4eFJraFk4e�e9e*k�feickit�e�r4ck�t�e�c�rF�ee�rie�9edr�cdc�r*atc�c*�r�edcicic�txieiaicitiricicdc%ieirFiiek' F�ex�raEvFxF�'eaEdtdeekde <br /> it <br /> Supervisor/Lead Senior Comments: <br /> d M d <br /> h I�� <br /> iM <br /> i <br /> I` <br /> I� <br /> �j <br /> 0 <br /> SUPERVISORILEAD SENIOR APPROVAL: <br /> 9 < <br /> i� OA II CHEG pFF LIST e Prao read reCarreel LAND USE# <br /> �I sCvrrect CONDITION(S) Lagged in LAND USE BODX? <br /> Eli 06 06 Rev 1199 <br />