Laserfiche WebLink
NOTE: PULL ALL PE YY CS (SEPTIC, WELL, ETC...) NL,;�KE COPIES FOR FILE <br /> P(e-- <br /> LAND USE REPORT APP# <br /> EHD RECEIVED APP.REFERRAL: n COMPLETE & SUBMIT BY I�Zl aZ �S <br /> DA DATE <br /> ATT/N: ( J n ✓� 1���L1 ��P i� <br /> SITE ADDRESS: u 7 4� L� r��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: Public sewage: <br /> SUMMARY OR COMMENTS: <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> �c�exic:kz�c 9cxdc 9c 9c�cx'x*4c is jc�Y�c�c'x sc ic�ic�e icxxic�cz�c�cx9cx�cXic is�c 9c�c�e is�'c�eE�c 9c icxxic icxx kie�e 4c icnisx�eKyc�cx�e 9c 3cx�'cnie x�ex�c 4cx�c icx�c <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA H CHECK OFF LIST. Proofread report? Correct LAND USE#? <br /> EH 06 06 Rev 1/99 Correct CONDITIONS)? Logged in LAND USE BOOK? <br />