Laserfiche WebLink
NOTE: PULL ALL PER T?fS (SEPTIC,WELL,ETC...) N-df-E COPIES FOR FILE <br /> LAND USE REPORT APP# <br /> S�o2 o n 5 COMPLETE & SUBMIT BY (o l b d3 <br /> END RECEIVED APP.REFERRAL: <br /> DATE <br /> DATE <br /> ATTN. <br /> SITE ADDRESS: a-s �o 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 /> I recommend: Approval Denial Continuance Inspector's Signature <br /> Supervisor/Lead Senior Comments: <br /> o� <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA II CHECK OFF LIST.• _Proofread report? Correct LAND USE#? <br /> EH 06 06 Rev 1199 Correct CONDITION(S)? Logged in LAND USE BOOK? <br />