Laserfiche WebLink
NOTE: PULL. ALL PERM`,,S (SEPTIC, WELL, ETC...) N E, COPIES FOR FILE <br /> LAND USE REPORT APP#✓ <br /> EHD RECEIVED APP.REFERRAL: -.) -� COMPLETE & SUBMIT BY .J -/y -0 <br /> DATE DATE <br /> ATTN: -J-ily\ V n &U/2 r l <br /> SITEADDRESS: /n(/ati ov rT p L 99 7 <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: T AJ C Public sewage: <br /> SUMMARY OR COMMENTS: <br /> I recommend: Approval Denial Continuance Inspector's Signatur <br /> Supervisor/Lead Senior Comments: <br /> iA <br /> SUPERVISORILEAD SENIOR APPROVAL: <br /> OAU CHECKOFF LIST: _Proofread report? Correct LAND USE#? <br /> EH 06 06 Rev 1199 11 Correct CONDlTIO;V(S)? Logged in LAND USE BOOK? <br />