Laserfiche WebLink
a <br /> 'ell" <br /> NOTE:'PULL ALL PERT 'S (SEPTIC, WELL, ETC...) 111KE COPIES FOR FILE �I <br /> LAND USE REPORT APP#_EA -O' ^Ap,.PV <br /> U� COMPLETE & SUBMIT BY " <br /> EHD RECEIVED APP.REFERRAL: .� ; i T <br /> D E DATE <br /> ATTN: i rM <br /> SITE ADDRESS: ( f t <br /> In completing the Land Use investigation, draw al 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: (7 <br /> SUMMARY OR COMMENTS: <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> kkkicickkkkicickkicick�k*irde�k�k�'ex$r�e�kicek�citici�ic�?ic�c�c-hick$ck�r�FicaF�c�Tcir�c3c9r�c9e9c$eicirxdr$icxviic�ciricic*icickic�ciciraEicdc��t4e�'t�e3e�eIcaF <br /> Supervisor/Lead Senior Comments: <br /> I� <br /> "IIAJI � a1 <br /> , . <br /> AIL <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> r <br /> I <br /> SDA II GHEC�'C OFFLIST �° Proofread reports Correct LAND USE <br /> EH 66 06 Rev 1199 Correct CONDITION(S)T�k Lagged to LAND USE BOOK? ;ff <br /> I� <br />