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A <br /> NOTE: PULL ALL PERNi.-,S (SEPTIC, WELL, ETC...) i,KE COPIES FOR FILE <br /> LAND USE REPORT APP# 0 P-6 <br /> EHD RECEIVED APP.REFERRAL: 1 I—9`t--G1 COMPLETE & SUBMIT BY -41- / 3 / <br /> DATE -L) ffo—t, <br /> DATE <br /> , <br /> ATTN: ( <br /> SITE ADDRESS: 0 5. L,14SAoO C— <br /> In completing the Land Use investigation, draw all Public Health factors on t e exhibit G.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 /> eq <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA II CHECK OFF LIST.- Proofread report? Correct LAND USE#? <br /> EH 06 06 Rev 1/99 Correct CONDITION(S)? Logged in LAND USE BOOK? <br />