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NOTE: PULL ALL PERMITS (SEPTIC, WELL, ETC...) MAKE COPIES FOR FILE <br /> LAND USE REPORT �✓ APP# PA /3"y '���J <br /> EHD RECEIVED APP.REFERRAL: Yh v COMPLETE & SUBMIT BY /01 ?EZ0-3E <br /> DATE DA <br /> ATTN: <br /> SITE ADDRESS: <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 Signature <br /> Supervisor/Lead Senior Comments: <br /> 7 <br /> SUPERVISOR/LEAD SENIOR APPROVAL: E <br /> OA II CHECK OFF LIST. Proofread report? Correct LAND USE#? <br /> Correct CONDITION(S)? —Logged in LAND USE BOOK? <br /> Ell06 06 Rev 1/99 - <br />