Laserfiche WebLink
7 _ <br /> NOTE: PULL ALL PERM�i (SEPTIC, WELL, ETC...) A.0 COPIES FOR FILE <br /> USE REPORT <br /> APP# <br /> EI1D RECEIVED APP.REFERRAL: I �-I-3- I COMPLETE & SUBMIT BY <br /> DATE DA' <br /> ATTN: <br /> SITE ADDRESS: y �� L,✓, n/; <br /> In completing the Land Use investigation, draw all Public Health factors on the exhibit (i.e.: sewage disposal, <br /> W <br /> supplies, etc...). Where necessary, on an attached piece of plain paper, draw completed map of area <br /> S <br /> population density, location of house, wind direction, etc.... <br /> Public water: C Public sewage: <br /> SUMMARY OR COMMENTS: <br /> 16 57 <br /> I recommend: Approval V Denial Continuance Inspector's Signature 7iU <br /> Supervisor/Lead Senior Comments: <br /> it <br />..- . � - ' 4 . .Ti�w-�O -�d"G-�•b ...Ltd �..-� 'a'� �-L�&-- �-GrQ.r�Bd ��K�'$ <br /> �o p <br /> �CJ"`•�'- <br /> I <br /> 52", �(/'DC/E-�A�y�CA. "�•�G'' `G.A- <br /> SUPERVISOR/L.EAD SENIOR APPROVAL: <br /> f OA //C/IECK OFF LIST: Proofread report? Correct LAND USE#? <br /> FH 06 06 Rev 1/99 Correct CONDIT/ON(S)? _Logged in LAND USE BOOK? <br />