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k <br /> NOTE: PULL ALL PERNrl-rS (SEPTIC, WELL, ETC...) ivx�,KE COPIES FOR FILE <br /> LAND USE REPORT APP# 44- 00-0_3 <br /> � <br /> 1� <br /> EIiA RECEIVED APP.REFERRAL. � COMPLETE & SUBMIT BY <br /> DATE / DATE <br /> ATTN: <br /> 'SITE ADDRESS: I -- <br /> In completing the Land Use investigation, draw all Public Health factors on the exhib/it (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 /> I recommend: Approval Denial Continuance Inspector's Signature <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> (7A PI CHECK�p'E+T �"ARM9 Fraojread eport '�� Garrett LAND U5E# <br /> EH 06 06 Rev 1/99 � '-"Gutrect CU1t'DITION{S} �Lt�gged rir LAND tISE$OCJIC7 <br />