Laserfiche WebLink
JHlIn// <br /> NOTE: PULL ALL PERIftffS (SEPTIC, WELL, ETC...) 1h7KE COPIES FOR FILE <br /> Pit - <br /> LAND USE REPORT APP# Z-'14 - 0!3 a 7 _3,.'S14�&P <br /> EHD RECEIVED APP.REFERRAL: -� 03 COMPLETE & SUBMITBY 7Z 71273 <br /> DA _ 1 DATE <br /> ATTN: i7 Q <br /> SITE ADDRESS: ( ... 13 J , &L) L2In 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 /> n <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> �,**xx****��,�*+��**a,�*****:��,�,�**x,���:�,tt**,�,tr.�**�***,�,��***,��*tax*,t*,�*,�*****�*• � *�***xt���s�� <br /> Supervisor/Lead Senior Comments: <br /> a vic, <br /> / �-" Q �— <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA 77 CHECK OFF LIST: _Proofread report? Correct LAND USE#? <br /> EH 06 06 Rev 1199 Correct CONDITION(S)? _Logged in LAND USE BOOK? <br />