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LAND USE RL-PORT <br /> ! �� <br /> {/ App u 1 <br /> To Be completed and Submitted by <br /> Date Issued <br /> ADDRESS UPAS S VT T�f <br /> APPLICAN T uAMyi_� r <br /> PROPOSED USE/CHAHGE '/''j- <br /> In <br /> icf Sri✓- dirr i��T�-, <br /> nnn_�r r.ri r i it i <br /> In completing the Land Use investigation draw all Public Health factors on the cAibit. <br /> (i.e'.) Sewage disposal., water supplios, etc. Where necessary, draw complete map of <br /> area showing population density, location of housed, wind direction, etc„ on an attached <br /> piece of plain paper, <br /> Size of Parcel . a T <br /> Requirements sq.. ft. <br /> Public Water (name) L Aw t4)dL- Co, Public Sewerage (name) <br /> SU?*MY.OR COMMTS: <br /> h 4s- <br /> 2. <br /> 3. <br /> 4. <br /> On basis of above, I recommend:.- Approval Denial Continuance <br /> Signed <br /> FOR OFFICE USE ONLY <br /> Report to Planning Standard Paragraph -Approval Disapproval Continuance,' <br /> 1 • <br /> EH 06 06 3/71 11/83 500 <br />