Laserfiche WebLink
NOTE: PULL ALL PERY,_'S (SEPTIC, WELL, ETC...) T�KE COPIES FOR FILE <br /> LAND USE REPORT APP# SR - or 8�- <br /> EHD RECEIVED APP.REFERRAL:—/.2- 1/-Q/ COMPLETE & SUBMIT BY_ 17 �- <br /> DATE DAT <br /> ATTN: L <br /> SITE ADDRESS: 21 ,960 S- AVE- Tris C v <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 /> r� <br /> `1 <br /> 0 <br /> '1::;1 <br /> I recommend: Approval—l/- Denial Continuance Inspector's Signature <br /> Supervisor/Lead Senior Comments: <br /> o� <br /> 47 <br /> r <br /> a� <br /> - CTC f <br /> 1 <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA IL CHECK OFF LIST. Proofread report? Correct LAND USE i!? <br /> EFI 06 06 Rev 1/99 Correct CONDITION(S)? Logged in LAND USE BOOK? <br />