Laserfiche WebLink
NOTE: PULL <br /> ALL PERN,_rS SEPTIC, WELL, ETC...)`1 AKE COPIES FOR FILE <br /> LAND USE REPORT APP# L — <br /> EI-[D RECEIVED APP.REFERRAL:� 0 0� COMPLETE & SUBMIT BY <br /> ATE // DATE <br /> ATTN: 14JA <br /> SITE ADDRESS: a c�. .S f <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 /> . �• <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> Supervisor/Lead Senior Comments: <br /> r <br /> SUPERVISORILEAD SENIOR APPROVAL: - <br /> OA`FII CHECK OFF LIST: Proofread report? _Correct LANri USE#9 <br /> EH o6 06 Rev 1/99 Correct COIVDITION(S) "T` Logged in'LAND iTSE BOOK? <br />�� ____ <br />