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t � <br /> NOTE: PULL ALL PERMITS (SEPTIC, WELL, ETC...) Icy_-KE COPIES FOR FILE <br /> LAND USE REPORT APP#j17 <br /> EHD RECEIVED APP.REFERRAL: I b COMPLETE & SUBMIT BY A <br /> DAT <br /> SITE ADDRESS: c� �C_- � f� V�� �� '�-�' G'Lti.1- S <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: 3S <br /> J c <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> �Y�c�k3c�exieo4ic�k�'c9c�e�e�F9c�exxic�cic�4�4�ko2�r�eieicve*�e�c�'c�c�c�cdc�c�F�Y4c�c�Ya'c�cxsrxx�e7cxix�eicicxxicir:iiaXicicic�cx�cdc�eic�c�e9cie�c�F�c�c�c�Fie�'e9ric�'eie <br /> Supervisor/Lead Senior Comments: <br /> 6 <br /> aps <br /> c <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA H CHECK OFF LIST. Proofread report? Correct LAND USE#? <br /> Correct CONDITION(S)? Logged in LAND USE BOOK? <br /> E1106 06 Rev I/99 <br />