Laserfiche WebLink
'NOTE: PULL ALL PERMITS (SEPTIC, WELL, ETC...) MAKE COPIES FOR FILE <br /> ' LAND USE REPORT APP# /V <br /> E}ID RECEIVED APP.REFERRAL: 7- 3 - (,0 COMPLETE & SUBMIT BY 7 _ 00 <br /> DATE DATE <br /> ATTN: j, <br /> SITE ADDRESS: 10 3 7 [c• I rA GLG=,(- : <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 /> Pub Ic water: <br /> SUMMARY OR COMMENTS: <br /> H-10 (a <br /> 2 2- a -✓ ve r/Y7 <br /> ✓J V cz <br /> ,1 <br /> I recommend: Approval Denial Continuance Inspector's Signature <br /> �c�c*�x4c 9c 9c 9c�'c7c*x�c is 9cxX*xic it icx�c*icxicxxir�c�c�c it�F is it�c�F kicx�c 4c 9c�c 3c�F**ac is icx�c i4xx�c�c�e is icX4c icxsc is�c�c�cx�c�r de*iex��FX�c�'c�'exde 7k <br /> Supervisor/Lead Senior Comments: <br /> • ellP <br /> SUPERVISORILEAD SENIOR APPROVAL: <br /> OA II CHECK OFF LIST: Proofread report? Correct LAND USE#? <br /> EH 06 06 Rev 1/99 Correct CONDITION(S)? Logged in LAND USE BOOK? <br />