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LM <br /> NOTE: PULL ALL PERNTI'S (SEPTIC, WELL, ETC...) 1Vi'tiE COPIES FOR FILE <br /> LAND USE REPORT APP# <br /> BID RECEIVED APP.REFERRAL: 3COMPLETE & SUBMIT BY I <br /> DAT / ATE <br /> ATTN: <br /> SITE ADDRESS: 3 <br /> In completing the Land Use investigation, draw all Public Health factors on the exhibit G.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: /1t7 Public sewage: <br /> SUMMARY OR COMMENTS: <br /> I recommend: Approval Denial Continuance Inspector's Sigrtatu>!-e.�: <br /> f <br /> �c�F*�cxdc�c�c 4c icx9c�c is�cx9c�c�'cx9c�c do 7c dcxx�c 9c�c�Exxx�c�c 9c�c�Fx�c�c is is icx�Fx�c*�E�c�F 9c is*�c�c�e�F�c 9c�c�r>c�F�c�'c�ic��cx�c�'c�'c�'c�c�c 9c a"c�c�c�c is is is 4c�Fx <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 />