Laserfiche WebLink
s <br /> NOTE: PULL ALL PERI.__TS (SEPTIC, WELL, ETC...) _ AKE COPIES FOR FILE <br /> LAND USE REPORT APP# <br /> EHD RECEIVED APP.REFERRAL: <br /> !X OA COMPLETE & SUBMIT BY <br /> DATE <br /> ii DA FE <br /> ATT N• // _l0 v;-;, 5 ke, <br /> ) <br /> SITE ADDRESS: � to a -5 e d . LS n <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 /> 01 <br /> - 03 -z4vzre� <br /> Ut- <br /> 01 <br /> A A <br /> J , <br /> I recommend: Approval Denial Continuance Inspector's Signature o <r <br /> ***ie*************ie**********iexx*ic ic**************dc******ic***ic***********ir ic•***:c* is*ic****ie is** <br /> Supervisor/Lead Senior Comments: <br /> l <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA II CHECK OFF LIST.• Proofread report Correct L ND USE#? <br /> HFI 06 06 Rcv 1/99 _.Correct CONDITION(S)? Logged in LAND USE BOOK? <br />