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NOTE: PULL ALL PER? FS (SEPTIC, WELL, ETC...) P 'KE COPIES FOR FILE <br /> LAND USE REPORTnn APP# Pik --U V LOL �) _ <br /> EHD RECEIVED,APP.REFERRAL: 9/10/02-QZ COMPLETE & SUBMIT BY sv-gz0 � <br /> DAT // DAT <br /> [/ <br /> ATTN: �Pyl r) F� ✓ In 4? V <br /> SITE ADDRESS: Fj 1,1 R D .S - 9Q� ✓lJ� red sj4 <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: 1 <br /> 3 TC <br /> - /��7LGfr't�i� 7� �.9�•- ��� ./YI2! %' i 4'.'Y.-i? 5+�. .-1,..l <br /> ri <br /> I commend: Approval Denial Continuance Inspector's Signature <br /> *d�:�xxFxax*�x*x*xxx***�****x�xxx,�xxx��x*xx,�xxx�x*�*Kx*xxxKx��xxxx*xxKxxxxx*xxx;.xx�xxsxx+xxx <br /> ,Supervisor/Lead Senior Comments: <br /> 1607© y <br /> ,rPV VV <br /> Jz <br /> . s <br /> t <br /> `/t• - .Qj Q v Fri r "cc.� o f Y .�.j _ <br /> u <br /> ry <br /> SOPERVISOR/LEA>S'SENIOR APPROVAL: r <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? Y/ <br />