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NOTE: PULL ALL PERATS (SEPTIC, WELL, ETC...) IV1r,fKE COPIES FOR FILE <br /> PORT APP# <br /> LAND USE RE <br /> �� COMPLETE & SUBMIT BY ` Z <br /> EHD RECEIVED APP.REFERRAL: A <br /> k <br /> D)4AEDA £ <br /> ATTN: V <br /> SITE ADDRESS: O <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 co 1 e p <br /> showing population density, location of house, wind direction, etc.... <br /> Public water: Public sewage: <br />` SUMMARY OR COMMENTS: <br /> 2Z- � <br /> I recommend: Approval <br /> lII�Deniat Continuance Inspector's Signature <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISORILEAD SENIOR APPROVAL: <br /> OA II CHECK OFF LIST �` ��'> Proofread report . <br /> 17H 06 06 Kev 1199 �' <br />