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LAND USE REPORT :: APP"2.), <br /> ), <br /> EiiA RECE1N El):SPP.REFERiLaL: <br /> aY q COMPLETE & SUBMIT BY )q-5H! <br /> DAT13F DATE <br /> ATTN: J; (r Va ri if) L) re_n <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 /> I <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> ir:F is eF irkir it ie it it ie ie ie it it irkec irxirk k$r is irxkkic irkkkkkkirkkir is ie irkkkkkiekckkkkkkkkkckkc,6 it irk*ir 4r aF it k ie ie iexir ie ie ie <br /> Supervisor/Lead Senior Comments: <br /> C - - - <br /> ce'l <br /> LAND USE CHECK OFF LIST. <br /> SUPERVISOR/LEAD SENIOR APPROVAL: Did you proofread the report? <br /> DID YOU USE THE CORRECT: <br /> _Land Use#? <br /> Condition(s)#? <br /> VDid you log it as completed? <br /> �i <br />