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LAND USE, REPORT � �� <br /> APP 11 1 V(S� G U� �P :•. <br /> To Do completed and Submitted by 2 -2-0 (�0" <br /> Date Issued <br /> ADDRESS UPA 1 N <br /> APPLICANT'S NAME ADDRESS <br /> PROPOSED USE/CHANGE <br /> In completing the Lard Use investigation draw all Public lloalth factors on the exhibit. <br /> (i.e.) Sewage disposal, water supplios, etc. Whero necessary, draw complete map of <br /> area showing population density, location of housed, wind direction, otc„ on an attached <br /> Piece of plain paper. " <br /> Size of Parcel Requirements sq, ft. <br /> Public Water (name)_ ' Public Sewerage (name) <br /> SUMh RY.OR OOMMENTS: <br /> 1. .. <br /> 2. <br /> J <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 /> EH 06 06 3/71 11/03 500 <br />