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NOTE: PULL ALL PERMS (SEPTIC, WELL, ETC...) N..-EKE COPIES FOR FILE <br /> LAND USE REPORT APP# 99- <br /> EHD RECEIVED APP.REFERRAL: -q-GC" COMPLETE & SUBMIT BY / V0 _Q Q <br /> DATE ,�I Y - DATE <br /> f1 <br /> ATTN: J �� S � <br /> SITE ADDRESS: Milo /: : Z2 , d j ,'4 6&-4,n, <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: 4�K/ .jjr Public sewage: L r' �v d�t� S,e") e u ` t <br /> SUMMARY OR COMMENTS: <br /> / o r <br /> l <br /> IAZ re <br /> J � <br /> 7, 4 d <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA II CHECK OFF LIST. Proofread report? Correct LAND USE#? <br /> EH 06 06 Rev 1/99 Correct CONDITION(S)? Logged in LAND USE BOOK? <br />