Laserfiche WebLink
PULL ALL PET-,,__:TS (SEPTIC, WELL, ETC...r..,,AKE COPIES FOR FILE <br /> LAND USE REPORT APP# ' -Da) <br /> EHD RECEIVED APP.REFERRAL:DAT COMPLETE & SUBMIT BY <br /> ATTN: J DS P— Po 61 Gt i1 e,S DATE <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: rcv Public sewage: <br /> SUMMARY OR COMMENTS: <br /> / /�G✓G�iYt� 171 l� k a� c• U a� Cf inxnwl <br /> 61 <br /> Jit-Off. — VV -l� - <br /> I recommend: Approval Denial Continuance Inspector's SignatureL/�W 7- <br /> Supervisor/Lead Senior Comments: <br /> - 0 3 0% <br /> 71 of <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA H CHECK OFF LIST. Proofread report? Correct LAND USE#? <br /> EH 06 06 Rev 1/99 Correct CONDITION(S)? Logged in LAND USE BOOK? <br />