Laserfiche WebLink
NOM PULL ALL PERK (SEPTIC, WELL, ETC...) X -e E COPIES FOR FILE <br /> J. <br /> LIM USE REPORT APP# L/q --OO 39 <br /> EHD RECEIVED APP.REFERRAL: q-�2 9 ...63 COMPLETE & SUBMIT BY AS 4P - f) <br /> DATE f DATE <br /> r �� T I_S�/�� <br /> i ATTN: �p - <br /> SITE ADDRESS: _ j 9 !J,!5 y .S LSd17 f2 <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: AJA Public sewage: I v <br /> SUMMARY OR COMMENTS: <br /> (� psk <br /> I recommend: Approval Denial Continuance Inspector's Signature/1fgUk17z;9j <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISORILEAD SENIOR APPROVAL: <br /> EH 06 06 Rev 1/99 # r t �� Carrect CONDlTI01'S) ��Logged In L�NIJid.4E SOOIC� : <br />