Laserfiche WebLink
Z- G <br /> NOTE: PULL ALL PERZTS (SEPTIC, WELL, ETC...) MAKE COPIES FOR FILE <br /> LAND USE REPORT APP# _> -01 - Q3 <br /> d <br /> EHD RECEIVED APP.REFERRAL: 3 —.)—C)—01 COMPLETE & SUBMIT BY q - W -U/ <br /> DATE KATE <br /> ATTN: ke-e-nflt- 1Y1'Je /le r <br /> SITE ADDRESS: 3/��' J . ,�,.. ,-,,_ ted ", L s C ," -/ v <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:A . <br /> t/�S <br /> VV V <br /> I recommend: Approval Denial Continuance Inspector's Signatur � <br /> �c�c:Fic*�cs'rxicxic>F is icxxic�c�F�c�c�c*�Ex*ir�Fx7cx�r it is icx�cx�c i�xxK�c is*�c is*�cxx*ic�c is is is rc�c�c�cxicx�cx is is�cxxicxis�cxicx�cxic icxxix dx is�Yx <br /> Supervisor/Lead Senior Comments: <br /> - <br /> l-f--. 1� :r� 3 «.tel ✓ ✓ ✓ j ,� <br /> SUPERVISORILEAD SENIOR APPROVAL: <br /> OA II CHECK OFF LIST.* Proofread report? Correct LAND USE#? <br /> EH 06 06 Rev 1/99 Correct CONDITION(S)? Logged in LAND USE BOOK? <br />