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16 Ss <br /> NO i"E: PULL ALL PERMITS (SEPTIC, WELL, ETC...) MAKE COPIES FOR FILE <br /> ,AND USE REPORT APP#S — / — 8 <br /> EHD RECEIVED APP.REFERRAL: ,3-x7-01 COMPLETE & SUBMIT BY (4- 1 — p I <br /> DATE DATE <br /> ATTN: �--e o.r� t r�)Uk A t e. sc <br /> SITE ADDRESS: _ 7QTrac- <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: N Public sewage: p <br /> SUMMARY OR COMMENTS: <br /> 2 P - - "-'J I .-r. k CTI <br /> 2 . _-,r��m� ,�F�( �, �'n� '..:.�s �v��ti� �nr�s��u.ricv�% �i-f�►<� <br /> -v <br /> I recommend: Approval V Denial Continuance Inspector's Signature11' k 'r , 3 <br /> �k4e�rir�c�r�r�r�2�r9e*dc*9c*�c�r�r�r9c4c�e�E�iair�edtre�+c�cx�cxxx�eie�'e�'t�9c�k*irirdeie4e�cie�e9e9r9e�e�c�c�c�e�F�c**�c�c�'e�c�c�'c�cxieieic�tr4c9e*9e�e�rieiricic�eie�cic <br /> Supervisor/Lead Senior Comments: <br /> AAA <br /> . ? <br /> 72 ' 03 <br /> SUPERVISORILEAD SENIOR APPR VAL: <br /> OA It CHE K OFF LIST.• Proofread report? Correct LAND USE V <br /> EH 06 06 Rev 1/99 Correct CONDITION(S)? Logged in LAND USE BOOK? <br />