Laserfiche WebLink
/C&7 <br /> NOTE: PULL ALL PERMITS (SEPTIC, WELL, ETC...) MAKE COPIES FOR FILE <br /> q)F- s/ <br /> LAND USE REPORT ( �8`yd APP# 514 - go -,5 <br /> EHD RECEIVED APP.REFERRAL: � J- COMPLETE St SUBMIT BY / — (� / Y <br /> DATE / I- DATE <br /> ATTN: �e F�I,S e. ( / <br /> SITE ADDRESS: P S �ZG�/] /SS Lac 4 <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: IVA Public sewage: Ala <br /> SUMMARY OR COMMENTS: <br /> b�MD <br /> / G <br /> z / o3 <br /> 05- <br /> ;2Z <br /> s;2Z 0 <br /> 0Z <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> Supervisor/Lead SeniQs Comments: <br /> 0 <br /> L <br /> 03 if <br /> :D <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA 11 CHECK OFF LIST.• V Proofread report? _Coned LAND USE#? <br /> 11 __,_--Correct CONDITION(S)? ,L <br /> EH W 06 Rev I/99 ogged in LAND USE BOOK? <br />