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NOPE: PULL ALL PER _TS (SEPTIC, WELL, ETC...) _AKE COPIES FOR FILE <br /> LAND USE REPORT APP# 5 - 29 -1.3 <br /> EHD RECEIVED APP.REFERRAL. 7 9 6 1 COMPLETE & SUBMIT BY — ? —qY <br /> 6AT9 I <br /> DATE <br /> ATTN: �62 ; k_)n m a <br /> SITE ADDRESS: <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 /> , <br /> hd <br /> r r <br /> M / <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> is ie�F ie is is is*xx�c is�c�c�c�F�c�F�c*i'e�r is�e�e�e ie is�'cx x�Fxscxxxie�k�e rx ie�e ie�F is�c is�e�e�e�e 9e;F�F ie ie�c ie ie ic:c ie is�e�eX�'c�c*ic ix ie ie�k:k9ekx*:F' aE <br /> Supervisor/Lead Senior Comments: <br /> PL <br /> . D <br /> IV <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA II CHECK OFF LIST.• Proofread repo ? Correct LAND USE ? <br /> FI1 06(u,Rev I/()() Correct CONDITION(S)? Logged in LAND USE BOOK? <br />