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NOTE: PULL ALL PERMI`x S (SEPTIC, WELL, ETC...) NL-��E COPIES FOR FILE <br /> LAND USE REPORT ArmQV <br /> -r-v <br /> EIID RECEIVED APP.REFERRAL- ! �- COMPLETE & SUBMIT B) I'1a 7A `L) I <br /> DATE DATE <br /> y� <br /> ATTN• Ick r TT/I <br /> SITE ADDRESS: a,L4 :)L L4 0L 5 , <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 /> f <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OAIT <br /> �CI#ECK:()]FUST Pro_sfra r1 r!?;1� Garrecf T.�3NP USE# <br /> ? ogge�an�D USZE.WC?OK <br /> EH 06 06 Rev 1199 "` �CarreC!C4N I7I�+ fS •,_,_. <br />