Laserfiche WebLink
I' <br /> NkOTE: PULL ALL PERMITS (SEPTIC, WELL, ETC...) NV KE COPIES FOR FILE <br /> u <br />' LAND USE REPORT APP# <br /> it k& <br /> a, 3 <br /> EHD RECEIVED APP.REFERRAL: 1 �� COMPLETE & SUBMIT B <br /> DATi✓/ / TE <br /> ,yy <br /> ATTN: <br /> SITE ADDRESS: � <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 /> - cam <br /> G � <br /> rt <br /> ZW- <br /> 4E <br /> I recommend: Approval �/ Denial Continuance Inspector's Signatu <br /> *$c�e is�c is*ir�r$ex9r*ie le vfek`dr�eX�c*�'ek,F !t�r k�c je 9e�c$r is�c F�r 3c F 4rx 4r is it e i*dc 9ek�r EFxx$r cK.'cXic jc s'c do ic9c�ck9c 3c dt 3e F '9e�c is�c$s 4cx�r aFxiex <br /> Supervisor/Lead Senior Comments: <br /> V II <br /> .E <br /> I <br /> i� <br /> u <br /> II <br /> r <br /> !I <br /> I: <br /> SUPERVISOR/LE'AD SENIOR APPROVAL: <br /> 19 <br /> I <br /> OA II CFEGI OFF LIST Proo read re ort Correct LAND <br /> f . n LAND USE,: <br /> t r Correct CONDI7IOY(S) <br /> EF106 06 Rcv 1199 N <br /> .Jx <br /> -. 8 <br /> - <br /> I <br />