Laserfiche WebLink
NOTE: PULL ALL PER ,,t'S (SEPTIC, WELL, ETC...) (?lckE COPIES FOR FILE <br /> LAND USE REPORT APP# A4 S - o J- f <br /> r <br /> MID RECEIVED APP.REFERRAL: ' 7-0 COMPLETE & SUBMIT BY `a <br /> DATE DATE <br /> ATTN: QCzl1 n 1e AIL4 e if <br /> SITE ADDRESS: &L 2 LAj , <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 densis , ocation of house, wind direction, etc.... <br /> Public water: fn, <br /> Public sewage: <br /> SUMMARY OR COMMENTS: J <br /> 2 <br /> s <br /> /7 <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> Supervisor/Lead Senior Comments: <br /> d <br /> r <br /> r <br /> 0 3 or-araC t rut. <br /> ; 03 <br /> e <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> Ll <br /> DA II CH, GK OFF lS7'€ 's Proofread report? Correct LAND USE#? Y <br /> 3 � Garreet CONDITION(S)? ' a , 'La Berl in LAND USE BOOK?, <br /> EH 06 06 Rev 1199 ' ' g <br />