Laserfiche WebLink
NOTE: PULL ALL PERM TS (SEPTIC, WELL, ETC...) IZAKE COPIES FOR FILE <br /> LAND USE REPORT APP# <br /> EHD RECEIVED APP.REFERRAL: (0-18-9q COMPLETE & SUBMIT BY OC,�—, �) [ ( ' <br /> DATE DATE <br /> ATTN: <br /> SITE ADDRESS: J qTn JA 1T e r n e- C4 7T r"3 ie <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 d sity, location of house, wind direction, etc.... <br /> Public water: Public sewage: <br /> SUMMARY OR COMMENTS: <br /> J <br /> _ Il - o3 <br /> i 02 ,�z <br /> is ►5al <br /> 02) - s-� " <br /> 01 L �oL tZu sd. �.� <br /> I recomme : Approval Denial Continuance spector's Signature <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISORILEAD SENIOR APPROVAL: <br /> OA II CHECK OFF LIST.• _Proofread report? _Correct LAND USE#? <br /> I If ua 06 Rev i;Q4 11 Correct CONDITION(S)? Logged in LXVD USE BOOK? <br />