Laserfiche WebLink
r NOTE: PULL ALL PERMITS (SEPTIC, WELL, ETC...) MAKE COPIES FOR FILE <br /> LAND USE REPORT APP# L l4--a o"g <br /> EHD RECEIVED APP.REFERRAL: 11— lb-C" COMPLETE & SUBMIT BY R_ S 1 'I 1�-al 'O 0 <br /> DATE /r DATE <br /> ATTN: Jeff <br /> SITE ADDRESS: q VJ 1red., <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 /> 06 <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> Supervisor/Lead Senior Comments: <br /> S 4' <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> 140-4 II CITE OFF LIST��Proofread cepa"rt? a orrrert L:4ND USE#? <br /> ;��; Carrect CDIVDITI4N S 9 ;Y 'Lo ed ue4ND iISE B04]'!? <br /> E H 06 06 Rev 1199 <br /> ,a- . v::a _ a, - � �"iT"_'`: .,-� .€:r,��,.:;�s:�, t'.as«::z �.. ,<�;:'.Re�' '.'�•y: .i,-..t:�?:.�'.. <br /> .w. <br />