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LAND USE, REPORT . <br /> APP <br /> To Be completed and Submitted by <br /> Date Issued <br /> ADDRESS UPA i ,4..3 � 1,A J <br /> APPLICANTIS IIAME 4irr��.G/�%ice re ADDRCSS/ <br /> PROPOSED USE/CtUalGE �f a -9''. /G-. • �/� Pc� o Cj PF i� r <br /> In completing theIa Uso twos on draw all Public Health tactors on the exhibit. <br /> (i.e'.) Sewage disposal, water suppliou, etc. Where necessary, draw complete reap of <br /> area showing population donsity, location of housed, wird direction, etc„ on an attached <br /> Piece of plain paper. <br /> Size of Parcel _�W, � Requirements sq. St. <br /> Public Water (name)�jf;,i,� w��/ Public Sewerage (name)�,�i;�q <br /> SUMMARY.OR OOMM-TTS: . . <br /> 2. <br /> On basis of above, I recommend:.. Approval por <br /> xal, Continua.pco <br /> Signed <br /> FUR OFFICE USE ONLY <br /> Report to PlannLng Standard Paragraph Approval Disapproval Continuance*C] <br /> _ • ki ._ . <br /> EH 06 06 3/71 11/83 500 <br />