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s <br /> Z—cn,- <br /> NOTE: PULL ALL PER1ViI TS (SEPTIC, WELL, ETC...) V AKE COPIES FOR FILE <br /> LAND USE REPORT APP# f'/7 ,��. ` 45 ����� <br /> EHD RECEIVED APP.REFERRAL: Ll /0'5 COMPLETE & SUBMIT BV #I <br /> D DATE <br /> ATTN: <br /> SITE ADDRESS: c)) 3 50 S " "`'`" <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: Approval Denial Continuance Inspector's S <br /> �kieie�ix:E�t9r�c�e$ekdeir$'s�ck�Fit�c9e�Flririe�'skaF$r���ekie�E�c�k�r�'e�F�kdedr�ciciv3cvFdc$ctF�Fxxxieakdr�c$irxxdcve' $uric' �c�ele��kiricxkac$exxieieic <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISORILEAD SENIOR APPROVAL y/ <br /> ©d' l CHECK 4FFLIST. = .Proafrerrd report? Correct LAND USE#9 4: <br /> r � � <br /> EH 06 06 Rev 1/99 E Correct COIYDITTON{Sj Lagged in Lf3ND,iTSE Bb4l�? <br /> �.. <br />