Laserfiche WebLink
gm <br /> NOT7E: PULL ALL PERM'S (SEPTIC, WELL, ETC-) NkKE COPIES FOR FILE <br /> LAND USE REPORT APP# /�'1 S- C�C7� 30 <br /> EHD RECEIVED APP.REFERRAL:--q11 S10) COMPLETE & SUBMIT BY. 5-6� <br /> DADATE <br /> ATTN: 11 le-r djar 7r6 <br /> SITE ADDRESS: All AC 0 e <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: �1y,/ Public sewage: <br /> SUMMARY OR COMMENTS: <br /> 1p U , v z <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> Supervisor/Lead Senior Comments: <br /> r <br /> r <br /> SUPERVISORILEAD SENIOR APPROVAL: <br /> OA Tl CHECK OFF IIST. _ g Pr aofread report ry ` Correct LAND USE#? <br /> r � Correct CO�VDIipg- TION(S)9 Logged rn LAND USE BOOS? <br /> EH 06 06 Rev 1/99 <br />