Laserfiche WebLink
r <br /> NOTE: PULL: ALL PERM.L_S (SEPTIC, WELL, ETC...) N CE COPIES FOR FILE <br /> LAND USE REPORT APP# S 14 - 00- aS <br /> EHD RECEIVED APP.REFERRAL: ✓ O v COMPLETE & SUBMIT BY (, / 10 //-)0 - <br /> DA E DATE <br /> ATTN: -re-✓-ile-; <br /> SITE ADDRESS: � CC) if GZ O <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 /> CLAA PPL <br /> No riA16 REQE <br /> LIIMMPl71 ro 136 MET JF AACU-ITY WANIti �'� Rtn�tsyN Rf 1 T 13 <br /> P�icPtiirT�� t0 Se"_ A,-E= &ZpSetC*&an M ig, ADtEsmyifyiy ffAZ"j)Z21u 0-901% <br /> JOY, of FL40jk SPA-CS - <br /> P4Pd- S t0 A E S U I "r 7tCrfl IF QW411 Ty W A'N 1 S to L'L19�ct.�5 ZO 14 XAot&A <br /> 5 toll <br /> r <br /> 2;� 4f L E a <br /> I recommend: Approval Denial Continuance Inspector's Signature . <br /> �c*ic is it 9c is�c�c�e F F ie irx�c is*9cx�c�e F F*ie F is k�c F Fxie ie'c�c�e ie*irxie ie**fie nF F'c�e*Fxc 9eXie�c ie ir�XF�c Je��e 9e 9e�e'c'e*ienie�e�c ie c F ie ie 9e�c�c E� <br /> Supervisor/Lead Senior Comments: <br /> nV <br /> -LZ&"� �o°'� Fes-i, - <br /> � v <br /> w <br /> Cu FL <br /> 3 - <br /> o. AY14 <br /> . <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 />