Laserfiche WebLink
t <br /> j x lei <br /> NOTE: PULL ALL PERMITS (SEPTIC, WELL, ETC...) M7XKE COPIES FOR FILE <br /> LAND USE REPORT APP# P f4-0 3---3 <br /> O COMPLETE & SUBMIT B ti '" • �- <br /> EHD RECEIVED APP.REFERRAL: - <br /> DA ATE <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 X Denial Continuance Inspector's Signature <br /> Z;��' %4 <br /> dr ie kir�r is is is 9t�e k9r�kic*9t Ic ale 9r�r vF�r�e�r$c*aF vF it 9e pie is�r*it�r�r�e 9c E k9r 9rxis knF 9r�r ak dr 4r o4�c jc 9c�e k�c 9r is vcxx*$c�c vF�9e vF�e�c�r is�c�4e Fxix is 3c mit�e kY 9c <br /> Supervisor/Lead Senior Comments: <br /> :a ' coofD <br /> � 4 <br /> SUPERVISORILEAD SENIOR APPROVAL: <br /> OA;II CHECK UFFLIST e Praofread reports Correct LANI3;USE# <br /> Correct C4NDITION(S} Logged in LAND USE BOOKS <br /> EH 06 06 Rev 1199 <br />