Laserfiche WebLink
NOTE: PULL ALL PERM S (SEPTIC, WELL, ETC...),,, KE COPIES FOR FILE <br /> ,Pe,�lslons �� <br /> LAND USE REPORT APP#�)p-00 -I0 �O <br /> G n, � C�,-h J 1'I 5 <br /> EHD RECEIVED APP.REFERRAL: 5 o� COMPLETE & SUBMIT BY ��a I 0 a <br /> DATV I 1 DATE <br /> ATTN: <br /> SITE ADDRESS: e l7 ] 1 �( �l 1 ry c n �lI�� 1.111- on <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 Signature <br /> Supervisor/Lead Senior Comments: <br /> r , <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> 0,111 CHECK OFF LIST: _Proofread report? Correct LAND USE#? <br /> EH 06 06 Rev 1199 Correct CONDITION(S)? Logged in LAND USE BOOK? <br />