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x / r <br /> NOTE: PUP, ALL PEi, {SEPTIC, WELL, ETC... E COPIES FOR FILE. <br /> LAND USE REPORT APP <br /> EHD RECEIVED APP.REFERRAL: � � COMPLETE & SUBMIT BY J q -21 <br /> DATE // DATE <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 /> ~ legs ��-�- L <br /> V �u <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> Supervisor/Lead S nior Comments'. <br /> .a <br /> w <br /> f �� • `r f <br /> SUPERVISORILEAD SENIOR APPROVAL: <br /> OA`l1;CFIE�JC OFF LI��" Proofread repori7 Gotreci L,91V&USE#? <br /> �G'orrect EONDITIDN(S) � ' Lagged irr LAND USE BOOR? <br /> a EH0606Rev 1/99 �t���� �' t°�� �r.�� �. �- � �� .ask_ a �- . �� � _: a ;� a <br />