Laserfiche WebLink
NOTA:: PULL ALL PERN,,S (SEPTIC, WELL, ETC...) :.EKE COPIES FOR FILE <br /> LAND USE REPORT APP# <br /> /� <br /> EHD RECEIVED APP.REFERRAL: O-10-2 COMPLETE & SUBMIT BY t4,' � �-6-a/ <br /> DATE I,�/� _` DATE <br /> ATTN: eLi Ah E-- C '� Wk0 Q. C <br /> SITE ADDRESS: -J-7 SQ( !,l• N ,C," ( $ CA . <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 /> �EQCIFST COM MFNTS �Ro� u5 �,g [JS oN UERN�ti {�cw{.5 RE: .�A�R7 S'(1j�rMtD <br /> Itry PeR�..,-rs �,�arET <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> Supervisor/Lead Senior Comments: <br /> • Q - D'"L <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 />