Laserfiche WebLink
NOTE: PULL ALL PERNIt TS (SEPTIC, WELL, ETC...) WAKE COPIES FOR FILE <br /> LAND USE REPORT APP# l r° - 9`�' - y <br /> EHD RECEIVED APP.REFERRAL: 1 —/_9 COMPLETE & SUBMIT BY <br /> DATE DATE <br /> ATTN• i o / kuyM 4A- / <br /> SITE ADDRESS: ,3ql a L S �� rJl� <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 /> GeJRr4 <br /> O S — PE R$ou S (tioT cMe.to y(56S <br /> 22;o y <br /> ((92:o2,1o2;0y loz66) No N(f-�15- �eLf 61vtilk"-) <br /> I recommend: Approval Denial Continuance <br /> xis*ie it ieXXiX ie is<ic is icxicxF is'c is is Jc is de:c ix ie is do is r.is k is c ie F ie is Fn:c ie**xai*F�exi ie cxs,. �"s ,�j� .K,O+l1D/�p ��{��� <br /> Supervisor/Lead Senior Comments: <br /> 6 <br /> .ate <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA H CHECK OFF LIST. Prooj <br /> EH 06 06 Rev 1/99 Correct CONDITIOP ,_, �- <br />