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/eC--. <br /> NOTE: PULL ALL PERMITS (SEPTIC, WELL, ETC...) MAKE COPIES FOR FILE <br /> LAND USE REPORT APP# <br /> EHD RECEIVED APP.REFERRAL:6 -�3 -0O COMPLETE & SUBMIT BY .3 �D U <br /> DATE DATE <br /> ATTN: Dent-) " A-,� w (le &,, <br /> SITE ADDRESS: 9 ,3 0 3 S. /9-L�S/j,". Ae C( . <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: Alj�" Public sewage: <br /> SUMMARY OR COMMENTS: <br /> h-,4 - 0--q <br /> it o <br /> G 2 7e 0 o_� � r fI �iu_.c_c <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> irieicxiciciricic�Y�c�c�edeir�e�Fic�Fa'c�c�c9c�F�'era'c�cie�e4e�Fic*�cicXx�'cir�cic�c�e�F�c�c9c:Etc*�Y*�c�kiricic�c9rxicic�c�c�E�e�Fitx�cicicx�c�'e3e�c**ic ie icdc�cieiex <br /> Supervisor/Lead Senior Comments: <br /> ll : Q 3 ✓ -- # 2 <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA H CHECK OFF LIST. Proofread report? X Correct LAND USE#? <br /> EH 06 06 Rev 1/99 V Correct CONDITION(S)? Logged in LAND USE BOOK? <br />