Laserfiche WebLink
NOTE: PULL ALL PERP QTS (SEPTIC, WELL, ETC...) C*E COPIES FOR FILE <br /> LAND USE REPORT <br /> EHD RECEIVED APP.REFERRAL: lCOMPLETE & SUBMIT BY �3D £ ASAP-RY- <br /> DATE <br /> ATTN: <br /> SITE ADDRESS: q j e-22A <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 /> .2 a-0 /- <br /> i7 o <br /> I recommend: Approval Denial Continuance Inspector's Signature— <br /> Supervisor/Lead <br /> ignature—Supervisor/Lead Senior Comments: <br /> V . <br /> iI <br /> f <br /> I <br /> i <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA II CHECK 6&LIST. <br /> Proo reaort d re <br /> f P Correct LAND USE#? <br /> EH 06 06 Rev 1199 d ; Correct CONDIT1. S 9 Lo <br /> ��j F 1 g�dr LAS . <br />