Laserfiche WebLink
I.N'drC PULL ALL PEWJS (SEPTIC, WELL, ETC-.) r; KE COPIES FOR FILE <br /> LAND USE REPORT APP# �_ QQ <br /> EHD RECEIVED APP.REFERRAL- 02COMPLETE & SUBMIT BY A A I <br /> SITE ADDRESS: W-) 7 (IV, Z-� a„IG�,ra� � - . T- <br /> ;4 <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 /> SUPERVISOR/LEAD SENIOR APPROVAL: ENTERED IN LAND USE LOG <br /> %DROP DEAD ON CALENDAR <br /> SOA Ir CHECK OFF LISW a <Proa fre ed report? Correct LAND IISE#9 <br /> EH 06 06 Rev 1144 €; <br /> Correct CONDITION(Sj7 Logged rn LA1VDtISE BODK� <br />