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NOTE: PULL ALL P�A-M�n eS (SEPTIC, WELL, ETC:: IM,-ACE COPIES FOR FILE <br /> LAND USE REPORT APP# <br /> ERD RECEIVED APP.REFERRAL:-7-17: COMPLETE & SUBMIT BY AiAl <br /> DATE <br /> DATE <br /> ATTN: <br /> SITE ADDRESS: .] E n -r <br /> In completing the Land Use investigation, draw all Public Healthctors 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, Iocation of house, wind direction, etc.... <br /> Public water: Public sewage: <br /> SUMMARY OR COMMENTS: <br /> I recommend: Approval V Denial Continuance Inspector's Signature r <br /> 9rE9cx�c�t�thia9cx't>ciiJrFx9r$c-Jricxiexcis$cic�rxxx�sic�r�Fielcx9c�Edc�F9r��9e:E$c9r�r�':�cdr�c�Fak�t9r$sk�exxx�t�Ficic$c9r�rF�F�cdc9t*Fdc'ea��'cdc�9rieirX <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISORILEAD SENIOR APPROVAL: <br /> 4.4 1 CHECICAFFLIST Praofread,�'report�, Correct LANG USE.#? " <br /> Ex 06 06 Rev 1/99 �' �correct CONDITIONS) Logged rn LAND USEBQDK? <br /> v,. <br />