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NOTE: PULL ALL PERMI-t'S (SEPTIC, WELL, ETC...) TVJLAKE COPIES FOR FILE <br /> LAND USE REPORT APP#_ L 00 - a <br /> EHD RECEIVED APP.REFERRAL: j+~r`� COMPLETE & SUBMIT BY rl.s f P 1 J- a r- yE> <br /> DATE DATE <br /> ATTN: Ilan a 4- <br /> SITE ADDRESS '7 - -'Cw f <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 /> s, <br /> Public water: Public•sewa e <br /> � g <br /> SUMMARY OR COMMENTS: <br /> a <br /> cUW►vnF,vl 7`RE¢ 7"ifLins,+„wi.5 - <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> Supervisor/Lead Senior Comments: <br /> I <br /> SUPERVISORILEAD SENIOR APPROVAL: <br /> �OA IIjCH��'K UFF`LIST �& '�`Proofread report?�� � Correct_I�9ND USE#9� } <br /> EH 06 06 Rev 1199 <br />