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COTE: PULL ALL PE"-XIS (SEPTIC, WELL, ETC...) aKE COPIES FOR FILE <br /> LAND USE REPORT APP# <br /> ESD RECEIVED APP.REFERRAL: 1 COMPLETE & SUBMIT BY 10 - `l Z_ <br /> DAA DATE <br /> ATTN: �Jna-e�Lx <br /> SITE ADDRESS: i <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 COMMEND <br /> /TS: <br /> t2d me C I/L , <br /> ' -/S" 6 %ol u✓ n0 v 'tc-h-ppmD� irlt 4 �"i> it- & See <br />' � L��,�y-- r,•, e/w asp an ��dt ��n �i�'a¢- �� _ �_ !-/�-. <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> *fie as ai iex$aF 3e•k�r$e�e$a4 arc trate aF*9c**3c ac k9r:E aF axx9c ns�r at:�ak$ak�r ie�e ae kie 4c aF�c aF do aE kdc de aF a@ie is ie ak ate arxxxxa}e 9e aye is de�r ate kale kaF`k�e$e ak�e 7'c 9r fe�e�e�xaF <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> !�A II CIfLGCK OFF LIST ProafreaaT report Correct." D&S,#9 <br /> x � ' Correct C©11FDIT?ON(S) Logged in,LAND A1VI1 USE BOOR 7 <br /> EH 06 06 Rev 1199 9 <br /> y <br /> 4 �r...x 7,_-,_....... „._sr '�_.?ke. '•..' ,-......,. .. .^,dx... ...... ..... _ars„ :r;`. <br />