Laserfiche WebLink
' JINOTE: PULL ALL PERMITS (SEPTIC, WELL,ETC...) MAKE COPIES FOR FILE <br /> LAND USE REPORT APP# <br /> EHD RECEIVED APP.REFERRAL: 'o?y-01, COMPLETE & SUBMIT BY5 J <br /> Z9 <br /> DATE DATE <br /> ATTN: <br /> SITE ADDRESS: <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 Signatur <br /> Supervisor/Lead Senior Comments: <br /> I <br /> SUPERVISORILEAD SENIOR APPROVAL: <br /> �'f)A II CHECK©F'F LISTE Proofread read? " ' Correct LAND 1�ISE# <br /> —'6 <br /> - as <br /> Carred CpNDITION(S}$ Logged in LAND USE BO(ll�� <br /> EH 0606 Rev 1199 .. ° ia ..:a;n�; � . .:_ a ., c _.� <br />