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` NOTE: PULL ALL PERMITS (SEPTIC, WELL, ETC...) MAKE COPIES FOR FILE <br /> LAND USE REPORT APP# M,. - !2&? - <br /> EHD RECEIVED APP.REFERRAL: Jl /`�/9e9 COMPLETE & SUBMIT BY <br /> DA TE D TE <br /> ATTN: 74 Gt i ."00/ham <br /> SITE ADDRESS: //-)O 44J 4,4,6-0 /CQ'. 4CA,a-�.,D� <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: &2 Public sewage: 4/0 <br /> SUMMARY OR COMMENTS: <br /> .- w <br /> 0� <br /> l -0 <br /> AAA <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> Supervisor/Lead Senior Comments: ) <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OAII CHECK OAF LIST.- L- Proofread report9' Correct LAND USE#? <br /> EH 06 06 Rev 1/99 �/ Correct COIVDITION(S)? Logged in LAND USE BOOK? <br />