Laserfiche WebLink
, .s C-1pt qAhJ Td <br /> NOTE: PULL ALL PERIVaTS (SEPTIC, WELL, ETC...)-.dAKE COPIES FOR FILE <br /> LAND USE REPORT APP# M-. -o <br /> £HD RECEIVED APP.REFERRAL: ' a 7`o COMPLETE & SUBMIT BY_ j 7 7:Q/ <br /> DATE DATE T <br /> ATTN: <br /> SITE ADDRESS: g <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: ` ,0 C/C.P A, 01515ublic sewage: C+ <br /> SUMMARY OR COMMENTS: <br /> /&., d 2 <br /> Cj <br /> 0 7-fr C-449 00 f <br /> / ' <br /> ,l r <br /> CA <br /> I recommend: Approval Denia! Continuance Inspector's Signaturel-ai <br /> *******tk$*Jr$r**xirie�ek*9c�c*ie**�c�4x1rF�rie*�t9e4t9c9ctck*�c** k�c**vE***3c**a't*9e�e***�ra�ek�t*vF*�r�r�r�c9e 4e****ic4ciex*c�cSeFir <br /> Supervisor/Lead Senior Comments: <br /> 0 Y, <br /> SUPERVISORILEAD SENIOR APPROVAL: „ <br /> 0A II CHECK OFF I;IST �� ` Proafreurt report?����`-B Correct L�1 ND USE#r <br /> IH 06 06 Rev 1199 Correct CO�VDI7ION(S} 4L -d '�n LAND USE BOOK? <br />