Laserfiche WebLink
NOTE: PULL ALL PERM?-iS (SEPTIC, WELL, ETC...) NrKKE COPIES FOR FILE <br /> LAND USE REPORT APP# J <br /> EHD RECEIVED APP.REFERR.-kL: I D�C-/ COMPLETE & SUBMIT BY—1 — 1 - a 6 0 0 <br /> DATE DATE <br /> ATTN• <br /> SITE ADDRESS: I c,0 a <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: rt --�—"` Public sewage: <br /> SUMMARY OR COMMENTS: <br /> ► . 6 <br /> 2 <br /> v 2 <br /> I recommend: Approval Denial Continuance Inspector's Signatur <br /> Supervisor/Lead Senior Comments: <br /> k\ Lip <br /> aL <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA 11 CHECK OFF LIST: _•i;Proofread report? Correct LAND USE#? <br /> EH 06 06 Rev 1/99 <br /> � lCorrect CONDITION(S)? Logged in LAND USE BOOK? <br />