Laserfiche WebLink
LAND USE REPORT APP#_ -A -99 i <br /> EHD RECEIVED APP. REFERRAL: " / COMPLETE & SUBMIT BY 41XI(?q <br /> DATE byrE <br /> ATTN• o )�( <br /> SITE ADDRESS: 7 <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: t <br /> sCEPA e ri• ^ DG-i N� <br /> i <br /> I recommend: Approval Y Denial Continuance Inspector's Signature <br /> it is�c ic�dc�F�c:F:::'sic:c ie it 9e�c ie kee ie icxxirxic*ic ie iexnie ie icx:i is ie a'e icxie is ie ie�e ie ie ie ie is it ie is�c ie is ec�Y ie�cniex�c�r$x�e r. XXXx�'cxXic iexie ix ie 9e:es:c <br /> Supervisor/Lead Senior Comments: <br /> LAND USE CHECK OFF LIST: _ <br /> Did you proofread the report? <br /> SUPERVISOR/LEAD SENIOR APPROVAL: DID YOU USE THE CORRECT: _ <br /> Land Use#? <br /> ondition(s)#? <br /> Did you log it as completed? <br />