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NOTE: PULL ALL PERMS (SEPTIC, WELL, ETC...) Nr-.KE COPIES FOR FILE <br /> e <br /> LAND USE REPORT APP# <br /> Wb [ . 7 , <br /> EHRA "fi <br /> l RECEIVED APP.REFER <br /> L: / O O COMPLETE & SUBMIT BY <br /> DDATE <br /> A <br /> ATTN: <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 recommend: ApprovalDenial Continuance Inspector's Signatur <br /> rr re r�xr�xrc rr r;rrxxrc rc icxie it is re rr re re rex xxrr>cxie>czrcx icxrcxzxi<rcxre irxrc r<x rcxr:rc is rex re rex�c ix rc i<rc rc rc rc is ix is rcxre rezre ix rc>:r.is re ie rr re re re rr ie <br /> Supervisor/Lead Senior Comments: <br /> D <br /> _ lr <br /> • <br /> t,y J� <br /> 617 <br /> 0 <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA H CHECK OFF LIST. Proofread report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE BOOK? <br /> l <br /> EH 06 06 Rev 1/99 <br />