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L6 <br /> NOTE: PULL ALL PERU' T'S (SEPTIC, WELL, ETC...) P I...KE COPIES FOR FILE <br /> Pre — <br /> LAND USE REPORT LU <br /> / APP# Pit-/- 0 ,-;5 x <br /> - Y5 � <br /> 619) <br /> EHD RECEIVED APP.REFERRAL: ( V COMPLETE & SUBMIT BY <br /> DATE DATE <br /> ATTN: <br /> SITE ADDRESS: 17i2lq <br /> In completing the Land Use investigation, draw all Publi 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 /> "2l.�Cr <br /> I recommend: Approval Jl � Denial Continuance Inspector's S' � <br /> Supervisor/Lead Senior Comment: a vJ�S <br /> a VZC Q. <br /> SUPERVISORILEAD SENIOR APPROVAL: <br /> OA II CHECK OFF LIST. Proofread report? Correct LAND USE#? <br /> Eli 06 06 Rev 1/99 Correct CONDITIONS)? _Logged in LAND USE BOOK? <br />