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�Bl <br /> ,NOTE: PULL ALL PERX,'S (SEPTIC, WELL, ETC...) ., *iKE COPIES FOR FILE <br /> LAND USE REPORT APP# <br /> EHD RECEIVED APP.REFERRAL: COMPLETE & SUBMIT BY <br /> DAT DA E <br /> ATTN: Jo <br /> SITE ADDRESS: Ij b p <br /> In completing the Land Use investigation, draw all Pu lic 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 /> I recommend: Approval Denial Continuance Inspector's Signature <br /> eiiciric�Ficixiciricia�Facicicicicxir4c9cx*ic�c�cx�Yxicic�cicicir�4*x�cicic*ic�cicic�"c�cicscir9cicic�'c*�'c�cx�'cxicic�cx*icic�eieicicicicr.r.icicic�cicicici:xicxz>c>: <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 />