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M <br /> LAND USE REPORT <br /> ._.. -wf�(Z.E- Pttai' L 1 C A IV <br /> APP # 1� =•�� <br /> To Be completed and Submitted by (6- 9 - $k <br /> Date Issued <br /> ADDRESS UPA f 7 7/ S i Alt E 5 CD <br /> APPLICANT'S NAI4E k)jU/#'Y?Dn ADDRESS <br /> PROPOSED USE/CHANGE <br /> In completing the Land Use investigation draw all Public Health factors on the exhibit. <br /> (i.e.) Sewage disposal, water supplies, 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 Requirements sq. ft. <br /> Public Water (name) Public Sewerage (name) <br /> SUMMARY-OR COMMENTS: <br /> 1. <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 /> o � <br /> EH r0 /71 C�. 11/83 500 <br />