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MOTE PULL ALL PERMYTS (SEPTIC, WELL, ETC...) MAKE COPIES FOR FILE <br /> LAND USE REPORT APP# A V0 — 2 <br /> EHD RECEIVED APP_REFERRAL: )(� — COMPLETE & SUBMIT BY p/ <br /> 0 <br /> DATE r <br /> ATTN: c f <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: _ /`,z) <br /> SUMMARY OR COMMENTS: <br /> C f i <br /> I recommend: Approval Denial Continuance Inspector's Si at .� <br /> Supervisor/Lead Senior Comments: <br /> r <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> 4�t11 CHECK OF DIST Pioafiead tepQrt� mm. � Garre�t LAND DISE#7 <br /> ; arreet�ONDTIOCS_J Lagged to LANA.USE BC?OIC7 ; <br /> EH 06 06 Rev 1199 .. :� at <br />