Laserfiche WebLink
<br />I <br />,I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br />ENVIRONMENTAL REVIEW REPORT FORMAT <br /> <br />Applicant Name: <br />Address: <br />Telephone: <br /> <br />Brief Description of Proposed Project: <br /> <br />Describe Location (Attach legal description and property dimensions): <br /> <br />Other Actions Needed or Anticipated <br />Zone Change: <br />Water Well Permit: <br />Sewage Disposal Permit: <br /> <br />By Applicant: <br />Yes No <br />Yes No <br />Yes No <br />Yes No <br />Yes No <br />Yes No <br />Yes No <br /> <br />Prepared By: <br /> <br />Date: <br /> <br />FnR COUNTY USE: <br />Date Submi tted: <br /> <br />Staff Review By: <br /> <br />Date: <br /> <br />15 <br />