Laserfiche WebLink
NOTE: PULL ALL PER>.TS (SEPTIC, WELL, ETC...) I,,.KE COPIES FOR FILE <br /> LAND USE REPORT APP# P Zj - `z3b (/J_) <br /> EHD RECEIVED APP.REFERRAL: COMPLETE & SUBMIT BY /T_03 <br /> DAT9 DATE <br /> ATTN: ' <br /> SITE ADDRESS: (,Aj . m r. �cslaLe ` r � o,,44A(-cb <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: Xe7` <br /> SUMMARY OR COMMENTS: <br /> a <br /> r,-Z-2— C41t / <br /> Zo. z,,� Gsh .Tr` v 2e <br /> .�,Gi. sc�•�LG=- .:er.. a � rC�� �-L '��.G�2I -�.�/`C�tls': , �.r�Ar <br /> ( .([► c a !'Ci i�Oyvi `� it t •/Trot Gs CGS maser [ ��c /2f Are <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> �; nx*xxKxx:�*x**��**x��*x*x�*�xxx**xxx*F*x�*�x**xKxxnKx�xxxxxxxxx�**x:x�:�� *+xx; r..rKx, ttx <br /> Supervisor/Lead Senior Comments: L / <br /> r / l ,AJ B f�L� �j! Awj, <br /> i <br /> 1 . 4/`�J V�/ � (f �n.✓.� /1L/vV / �d4.y }�/1 //�//y/T�/ / (iV`(! n ` <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA H CHECK OFF LIST. Proofread report? Correct LAND USE#? <br /> Ell 06 06 Rev 1/99 Correct CONDITION(S)? _Logged in LAND USE BOOK? <br />