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LAUD USE REPORT <br /> APP r S)ot—9B-s5- M 9 kt 57 <br /> TO Be completed and Submitted by —�2�—�� <br /> Data Issued <br /> ADDRESS U[-A, a SSD 86 ,2 Xcio A5, L001AIS �2d <br /> AlYLIGANT'S NAME '_Io CIYL',� 1C0 r— ADDRESS <br /> PROPOSED USE/GM E <br /> In complet' ng the Land Use investigation draw all Public Health factors on the e-xhibit. <br /> Sewage diapoeal, water supplies, etc. ZOra necessary, draw conplote -MAP of <br /> area showing'population density, location of housed <br /> Piece of plain paper, , wird dirsotion, etc„ on an attached <br /> Slue of Parcel Requirements sq. ft. <br /> Public Water (name) Public Sewerage (name) <br /> i <br /> SUMA-RZ OR OC)MMENTS: <br /> z <br /> 3. <br /> e. <br /> On basis of above, I recosaaend: Approval V Denial Continuance _ <br /> Signed ���� <br /> F(M OFFICE USE ONLY <br /> Re Port to Planning Standard Paragraph Approval 0 Disapproval Continuance 0 <br /> 5 <br /> /2 <br /> Di 06 06 3/71 <br /> 11/83 SOO <br />