Laserfiche WebLink
NOTE: PULL ALL PERM--S (SEPTIC, WELL, ETC...) N,-,,KE COPIES FOR FILE <br /> LAND USE REPORT APP# ,54 -00 -aZ <br /> EHD RECEIVED APP.REFERRAL: J-- 0 -V" COMPLETE & SUBMIT BY - <br /> DATE / DATE <br /> ATTN: T /1 Gf 1-/Yte./-S, tom/ <br /> SITE ADDRESS: <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 C21,01,1- <br /> 1 <br /> recommend: Approval Denial Continuance Inspector's Signature <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISORILEAD SENIOR APPROVAL: <br /> OA II CHECK OFF LIST: Proofread report? Correct LAND USE#? <br /> EH 06 06 Rev 1/99 <br /> Correct CONDITION(S)? Logged in LAND USE BOOK? <br />