Laserfiche WebLink
NOTE: PULL ALL PERMITS (SEPTIC, WELL, ETC...) MAKE COPIES FOR FILE <br /> LAND USE REPORT APP# <br /> EHD RECEIVED APP.REFERRAL: / COMPLETE & SUBMIT BY �� <br /> DAT Ad'- Rl�lq DATEATTN: ( f I Gt/1 P <br /> SITE ADDRESS: ` i°./�7 e/` 11 /L,21klya > <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 showing popul ation density, locatiattached piece of plain paper, draw completed map of area <br /> on house, wind direction, etc.... <br /> Public water: Public sewage: <br /> SUMMARY OR COMMENTS: <br /> I recommend: Approval tlp Dal <br /> -a 11 <br /> *x*Continuance <br /> Inspector's Signature <br /> xr-.4t' <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> 0.4 II CHECK OFF LIST.• Proofread report? Correct LAND USE#? <br /> EH 06 06 Rev I/99 Correct CONDITIONS . <br /> O' Ll _Logged in LAND USE BOOK? <br />