Laserfiche WebLink
NOTE: PULL ALL PERMITS (SEPTIC, WELL, ETC...) MAKE COPIES FOR FILE <br /> LAND USE REPORT APP# 711 S' - - y 9 <br /> r <br /> EHD RECEIVED APP.REFERRAL: 1 r J`� COMPLETE & SUBMIT BY L' _ — 9 9 <br /> DATE DATE <br /> ATTN: QCs W C;, <br /> SITE ADDRESS: s co, /0,1 <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 /> p�-} <br /> `� . <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> Supervisor/Lead Senior Comments: <br /> I I I ,oL-, <br /> j 03 <br /> 3 i4 7 <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> 0.4 If CHECK OFF LIST.• Proofread repo t? Correct LAND USE#? <br /> EH 06 06 Rev 1/99 Correct CONDITION(S)? Logged in LAND USE BOOB? <br />