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` NOTE: PULL ALL PERM S (SEPTIC, WELL, ETC... N�KE COPIES} S FOR FILE <br /> LAND USE REPORT <br /> APP# <br /> EHD RECEIVED APP.REFERRAL: —0 COMPLETE & SUBMIT BY 1 A <br /> DATE � f; <br /> DATE <br /> ATTN: <br /> SITE ADDRESS: j` . , <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 /> rte' 7 <br /> 2 <br /> k . <br /> I recommend: Approval Denial Continuance Inspector's Si-nature ,��;� <br /> �[7xC�t%fie 7k�'dc]F do iC i�C'Ii 1k]�C�[�de 7C�f 7�e)F*iia Fi[�t ii]C�C�[�[R iE iS vF�C�[�t$cXX]F**�iC�s*vF*de 7k 71[XX�[7�i 7r[�e]E�C�C 7�C]�]FXXiS�C'1[�c'�C 7P `JC*'e�t le iexixxxxxxee <br /> Supervisor/Lead Senior Comments: <br /> r� <br /> ft <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA II CHECK OFF LIST 1 : Proofread report? r COrIEct L,41VD USE 9 <br /> EH 06 06 Rev 1199 i r <br /> Correri CONDITI0IY(S) Lagged tit LAND(ISE BOOK <br /> :E� x <br />