Laserfiche WebLink
NOTE: PULL ALL PEPM fS (SEPTIC, WELL, ETC...) i",,kKE COPIES FOR FILE <br /> LAND USE REPORT APP# <br /> EHD RECEIVED APP.REFERRAL: 7 -10 -01 COMPLETE & SUBMIT BY <br /> DATE � �� f / DATE <br /> ATTN: �.+ 'f i <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 /> I recommend: Approval Denial Continuance Inspector's Signature <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA H CHECK OFF LIST.• Proofread report? Correct LAND USE#? <br /> E106 06 Rev 1/99 Correct CONDITION(S)? Logged in LAND USE BOOK? <br />