Laserfiche WebLink
MUTE: PULL ALL PERI` ,S (SEPTIC, WELL, ETC...) T KE COPIES FOR FILE <br /> LAND USE REPORT APP# <br /> EHD RECEIVED APP.REFERPUL: V�. COMPLETE & SUBMIT BY <br /> DATE DATE <br /> ATTN: <br /> SITE ADDRESS: 1-7 R 3 l� <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 Signatu : ta <br /> �4icxie�'ex*ic**ic�exiexixicicxxFre6icicye�eiricycicicicxxicieicxieicicicieieiciric'e*+e�rxicxxicicicicicicx4cicicic�'cie'eok9e�F�Yiexiexicxx �Y�e4e�e�'e$e�e <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 CONDITION(S)? Logged in LAND USE BOOK? <br />