Laserfiche WebLink
1 COTE: PULL ALL PEW,.IS (SEPTIC, WELL, ETC...) ,EKE COPIES FOR FILE <br /> of <br /> LAND USE REPORT APP# 5/4--99- 99 <br /> EHD RECEIVED APP.REFERRAL: I -/ -OIL COMPLETE & SUBMIT BY q— /y <br /> DATE DATE <br /> ATTN: J A/! <br /> SITE ADDRESS: .2,�j d <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 /> l(:69 <br /> I recommend: Approval_ Denial Continuance Inspector's Signature <br /> Supervisor/Lead Senior Comments: <br /> `f tbl <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA H CHECK OFFLIST., Proofread report? Correct LAND USE#? <br /> Eli 06 06 Rev 1/99 Correct CONDITION(S)? Logged in LAND USE BOOK? <br />