Laserfiche WebLink
� e <br /> NOTE: PULL ALL PERN'IYTS (SEPTIC, WELL, ETC...) *AKE COPIES FOR FILE <br /> 7'i M e <br /> LAND USE REPORT (� APP## J ) P- 9E -09 cek�roN <br /> EHD RECEIVED APP.REFERRAL: / COMPLETE & SUBMIT BY 0— a'7-'9 "/ <br /> DATE y� DATE <br /> ATTN: C'� �r � Y/1S Hn <br /> SITE ADDRESS: 5/00 W • 54- , )a t�Z - t- O d j <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: 'y"r Public sewage: 061-46— <br /> SUMMARY OR COMMENTS: <br /> KsHY /-z— <br /> 6 # "05 <br /> I recommend: Approval /"' Denial Continuance Inspector's Signatu�QA a� <br /> Supervisor/Lead Senior Comments: <br /> LES :DtJ Q l QA <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA //CHECK OFF LIST: _ Proofread report? Correct L4ND USE#? <br /> EH 06 06 Rev 1/99 Correct CONDITION(S)? _Lagged in LEND USE BOOK? <br />