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J Ff- <br /> NOTE: PULL ALL PERMIT'S (SEPTIC, WELL, ETC...) Nryl COPIES FOR FILE <br /> LAND USE REPORT APP# <br /> ERD RECEIVED APP.REFERRAL: COMPLETE & SUBMIT BY <br /> DAV E �QQ <br /> ATTN: J A III60j-e,� <br /> SITE ADDRESS: I 7�} <br /> q S �—� C—Q <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.... , J <br /> Public water: �j L Public sewage: <br /> SUMMARY OR COMMENTS: <br /> Dy /1 - / 0( v S e I <br /> rL <br /> I recommend: Approval ✓Denial Continuance Inspector's Signature <br /> Supervisor/Lead Senior Comments: <br /> Os <br /> YL�O� <br /> J I/ <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA II CHECK OFF LIST: _Proofread report? Correct LAND USE#? <br /> EH 06 06 Rev 1/99 _Correct CONDITION(S)? _Logged in LAND USE BOOR? <br />