Laserfiche WebLink
a <br /> NOTE: PULL ALL PERr*S (SEPTIC, WELL, ETC... ..,KE COPIES FOR FILE <br /> LAND USE REPORT APP <br /> EHD RECEIVED APP.REFERRAL: +J COMPLETE & SUBMIT BY o7 V U <br /> DATE DATE <br /> ATTN: J P nA z /r Jt-) e V <br /> SITE ADDRESS: Cf <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 /> —5 <br /> I recommend: Approval t, Denial Continuance Inspector's Signature <br /> Supervisor/Lead Senior Comments: <br /> SUPERVISOR/LEAD SENIOR APPROVAL: <br /> OA II CHECK OFF LIST.• Proofread report? Correct LAND USEV , <br /> El 106 06 Rev 1/99 Correct CONDITION(S)? Logged in LAND USE BOOK? <br />