Laserfiche WebLink
NOTE: PULL ALL PER.M1 1TS (SEPTIC, WELL, ETC—) MAKE COPIES FOR FILE <br /> LAND USE REPORT APP# <br /> EHD RECEIVED APP.REFERRAL: !)' j -9 9 COMPLETE & SUBMIT BY <br /> DATE DATE <br /> ATTN• Gl u o rn c, <br /> SITE ADDRESS: IS I <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 D Public sewage: <br /> SUMMARY OR COMMENTS: <br /> C� •' (7 <br /> I recommend: Approval X Denial Continuance Inspector's Signa re <br /> ir****-Jck*�r�r*:FPrx*:k******9t�r9rie*de*lair****e�ex9e*exde**kdedt�r*air*ie iei�***kie*k�esfe�ede****fit*$e ale**kir**dF*�e�'e�iedede�c*ir <br /> Supervisor/Lead Senior Comments: <br /> o S oR- -;L <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA II CHECK OFF LIST.- Proofread report? ..Correct LAND USE#?` <br /> EH 06 06 Rev u99 Correct CONDI7701V(S)? Logged in LA1VD USE BOOK? . <br />