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a— b <br /> NOTE: PULL ALL PERMITS (SEPTIC, WELL, ETC...) MAKE COPIES FOR FILE <br /> LAND USE REPORT APP# _ 9 -a T'"� _ <br /> EHD RECEIVED APP.REFERRAL: I 7 COMPLETE & SUBMIT BY — — apQO <br /> DATE DATE <br /> ATTN: <br /> SITE ADDRESS: a <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: �� J Public sewage: <br /> SUMMARY OR COMMENTS: � /�C4A. r_. <br /> t � <br /> r <br /> I recommend: Approval ✓Denial Continuance Inspector's Signature <br /> Supervisor/Lead Senior Comments: <br /> l <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA II CHECK OFF ZIST Proofread report? Correct LAND [TSE#? <br /> EH 06 06 Rei /99 ' ' Co <br /> USE BOOK <br /> rrect CONDITIONS) Logged rn LAND ' <br />