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n � <br /> NOTE: PULL ALL PERMITS (SEPTIC, WELL, ETC...) MAKE COPIES FOR FILE <br /> LAND USE REPORT APP# <br /> END RECEIVED APP.REFERRAL: COMPLETE & SUBMIT BY 0 — ?9 <br /> DATE DATE <br /> ATTN: J P �'F F c%e r <br /> SITE ADDRESS: / / Lf 5 / /f 1AJ P r /- L Al . . Lod , <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: flvFii 1H1J/f Public sewage: <br /> SUMMARY OR COMMENTS: <br /> A -2s-2� C,4�r/vs 3 /r'1P lJ��r Gid <br /> 6(j., k d „ <br /> f <br /> I recommend: Approval Denial Continuance Inspector's Signatvur_ rfdKi S� <br /> Supervisor/Lead Senior Comments: <br /> � // : 07 &� <br /> 90 : 0 <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA /I CHECKOFF LIST.• Proofread report V Correct LAND USE#Y <br /> EH 06 06 Rev 1/99 - J zCorrect CO:VDIT/ON(S)? Logged in LAND USE BOOK? <br />