Laserfiche WebLink
• J� <br />NOTE: PULL ALL PERMI i S (SEPTIC, WELL, ETC...) MICE COPIES FOR FILE <br />LAND USE REPORT <br />APP# P- 99- i� r'P_, P11c.j�,j <br />EHD RECEIVED APP. REFERRAL: I l ,�l C� /�J COMPLETE & SUBMIT BY i 9 / a-1 / 90) <br />DAT D E <br />ATTN: <br />SITE ADDRESS: I M 4-n gna cQ- eke-, TrA N <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: <br />SUMMARY OR COMMENTS: <br />Public sewage: <br />I recommend: Approval Denial Continuance Inspector's Signature <br />Supervisor/Lead Senior Comments: <br />�1 <br />SUPERVISOR/LEAD SENIOR APPROVAL: <br />EH 06 06 Rev 1/99 <br />OA II CHECK OFF LIST: _ Proofread report? _ Correct LAND USE #? <br />Correct CONDITION(S)? _ Logged in LAND USE BOOK? <br />