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LAND USE REPORT �� APP#��_, <br /> P- 99 - <br /> EHD RECEIVED APP.REFERRAL: � r� �-! COMPLETE a SUBMIT BY �---IqS/q'1 <br /> DATE D TE <br /> ATTIC: T Ct. V O rV-1 A <br /> SITE ADDRESS: "� 0 <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: eq lm eA <br /> SUMMARY OR COMMENTS: <br /> tai kle — SW AIf k f'R4 i 4,4.sg J-e <br /> V <br /> (Q) <br /> ct L'i AC. <br /> N / 1• Iwr r ff 'I Q�4II[4''bi. "h f f c.-�Y R !FS./(`•��r�`�— <br /> OQ!— ° I w i 3�77P r»- �-' am i'r_ C�/G°!J a,wJ r�►c�_ I f�4 <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> vc is is hex xxie�Y is�e isxx�c�t�c�c it do de�c dr x'*fie�e kfr�e it�t ic'.s:F ie it�t it 4r ri'7e ie ie nFkndcX9r�lr is�r is�F ie ie*at�F a't 9tx#fie ee de it it�r de$�t is is ie�F�F de��c itx9t 9r�kx�c ie ie <br /> Supervisor/Lead Senior Comments: <br /> cis• t,.�e:,�.r c���' --- <br /> LA�1D USE CHECK OFF LIST: i <br /> SUPERVISOR/LEAD SENIOR APPROVAL: D�/Did you proofread the report <br /> . ��.. � � II�YOU USE THE CORRECT:: <br /> +/ Land Use#? I <br /> Condition(s)#? <br /> Did you log it as completed? <br />