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NOTE: PULL ALL PERMITS (SEPTIC, WELL, ETC...) 1VIAKE COPIES FOR FILE <br /> a <br /> LAND USE REPORT APP# L'4 00 S <br /> EHD RECEIVED APP.REFERRAL: �j F COMPLETE & SUBMIT BY <br /> DATE DATE <br /> ' ATTN: l <br /> SITE ADDRESS: " <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 /> Public water: Public sewage: / <br /> SUMMARY OR COMMENTS: <br /> LLL <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> Eo606Re� ��9 UFFLIST �� Pronfreadrepv ?� CorrectLAlVDl7SE#? <br /> OA 1I CHECK <br /> 1` <br /> Correct ECJ►NDITI© (S}n Logged in Lfl11�D USEBQ©IC� P$ <br /> ; m <br />