Laserfiche WebLink
4. r� TW <br /> NOTE: PULL ALL PERMrrs (SEPTIC, WELL, ETC...) MAKE COPIES FOR FILE <br /> LAND USE REPORT APP# L 4 -o o <br /> a r� � ,B <br /> EFID RECEIVED APP.REFERRAL: ! - �of 'do COMPLETE & SUBMIT BY !4 <br /> DAVE DATE <br /> ATTN.- j n l/ <br /> SITE ADDRESS: <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 /> I recommend. Approval Denial Continuance Inspector's Signature <br /> Supervisor/Lead Sen' r Comments: <br /> SUPERVISOR/LEAD SENIOR APPROVAL: 1 <br /> eOA l'�CHECK OFF LIST ���` ��� Praafread repos_f� �€' `Gorr'ecf.�.�ND r3SE#9 � <br /> Correct COIVDITIDN(S)? " Logged fn LAND DISE BOl1K� � ; <br /> EH 06 06 Rev 1199 <br />