Laserfiche WebLink
L& <br /> ,NOTE: PULL ALL PERM ,S (SEPTIC, WELL, ETC...) N kE COPIES FOR FILE <br /> LAND USE REPORT APP#�' <br /> EHD RECEIVED APP.REFERRAL: COMPLETE & SUBMIT BY <br /> DATE DATE <br /> ATTN: _R , C 1- Co r i �nG n . <br /> SITE ADDRESS: I j � L 5 S �) (N rid I � n^ --� � ' C! <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 /> s/ <br /> I recommend: Approval Denial ontinuance Inspector's Signa / <br /> Supervisor/Lead Senior Comments: <br /> /-� �2 ' a 3 a� «R/t�4•�„-� .,tam-�-M•<-�- �,ri> <�n� <br /> SUPERVISORILEAD SENIOR APPROVAL: <br /> [50A II CHECK OFF LIST. Proofread report? _Correct LAND USE#? <br /> EH 06 06 Rev 1/99 —Correct CONDITION(S)? _Lagged in LAND USE BOOK? <br />