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NOTE: PULL ALL PERMri'S (SEPTIC, WELL, ETC...) NrfKE COPIES FOR FILE <br /> /OAII's to., <br /> LAND USE REPORT APP# <br /> EHD RECEIVED APP.REFERRAL:--1' J COMPLETE & SUBMIT BY �//U/� <br /> DA E inn DA� <br /> ATTN: � f�n YL e �u��'77t�. LP—,( — <br /> SITE ADDRESS: q,M (/v ' S - /CT � / C <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 /> /UQ <br /> 4 <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA H CHECK OFF LIST. Proofread report? Correct LAND USE#? <br /> EH 06 06 Rev 1/99 Correct CONDITION(S)? Logged in LAND USE BOOK? <br />