Laserfiche WebLink
NOTE: PULL ALL PERM I S (SEPTIC, WELL, ETC...) N[AKE COPIES FOR FILE <br /> LAND USE REPORT APP#�, /9� - 49- <br /> EHD RECEIVED APP.REFERRAL:__ COMPLETE & SUBMIT BY <br /> DATE DATE <br /> ATTN: A n Gti �v1 r W P �/7� eI� <br /> SITE ADDRESS: -5900 / /�Sn � �r !C C'I . Am R n 74S <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 /> ` v <br /> 6 <br /> L!i-h i , , : 1 i <br /> .R <br /> I o 2.Ay % /Z2v-/*3 <br /> 2 �o <br /> I recommend: Approval-v- Denial Continuance Inspector's Signature <br /> Supervisor/Lead Senior Comments: <br /> —v <br /> OIo��N � '�1mD (�.Q.Mi�- �tu 'RaWIhEN�ty� �2a {� tJ1lf)s�,61� <br /> "nn � <br /> C2. ac-Yrw.. t,JtA /b - IZ 91) <br /> ean -f) <br /> (0 <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA JI CHECK OFF LIST. _ Proofread report? _Correct LAND USE#? <br /> Eli 06 06 Rev 1:99 Correct CONDITION(S)? _Logged in LAND USE BOOK? <br />