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LAND USE REPORT APP# I) !Iq S <br /> EHP RECEIVED APP.REFERR.XL: "/ COMPLETE & SUBMIT B1' <br /> A E DA <br /> ATTN: /,a 1 !-4J pmtA <br /> SITE ADDRESS: 62 �-3 a a -7� h ttt— TC acs. <br /> In completing the Land Use investigation, draw all Public Health factors on the exhibit (i.e.: sewage disposal, <br /> water suppli^s, 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: 6+ <br /> llc—li--6 <br /> &t//1Z 4 v <br /> • <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> ie;e:c:e�e ic:e is ie�4x�'e ie�exdc ie*:k nc 9e�F:k�F�e�c ie ie�r:k ie Sex**itxix n�cX�e ie�e�e�E 3e ec�:acx�k 4c de iex�e**xic ie iex�e ie 4e�e�kxiexie�e 4e�F�F�e�e�c�c�e is is ie�c is�c�c <br /> Supen-isor/Lead Senior Comments: <br /> /4 eltyloye <br /> LAND USE CHECK OFF LIST: <br /> 1/bid you proofread the report? <br /> SUPERVISOR/LEAD SENIOR APPROVAL: DID Y USTHE CORRECT: <br /> and Use E#? <br /> _ ondition(s)#? <br /> Did you log it as completed? <br />