Laserfiche WebLink
NOTE: PULL ALL PERl`,.......S (SEPTIC, WELL, ETC...) IN--,do E COPIES FOR FILE <br /> LAND USE REPORT APP# ff- 0/---3(0/L /j <br /> EHD RECEIVED APP.REFERRAL: I �q� COMPLETE & SUBMIT Blr _ oZ —WoL oF � <br /> DATE DATE <br /> ATTN: JZ) <br /> SITE ADDRESS: <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 /> e „ <br /> I recommend: Approval Denial Continuance Inspector's Signature , <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br />! `,OA II CHECK,0,rF LISTi Proofread report?y Correct LAND USE#9 <br /> rte ob 05 Rev 1�9 @@� � �� Correct CONDITION{S)9 Logged in LAND LISE BOOK? <br />