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• G r LAND USE, REPORT <br /> APP <br /> • To Be completed and Submitted by '45 <br /> Date Issued <br /> ADDRESS UPA SS 0 ([ <br /> APPLICANT'S NAME " • ADDRESS /S79' <br /> PROPOSED USE/CHANGE <br /> In completing the Lard Use investigation draw all Public Health factors on the exhibit. <br /> (1.e.) Sewage disposal, water supplion, etc. Fdherc necessary, draw complete map of <br /> area showing population donsity, location of housed, wind direction, etc„ on an attached <br /> piece of plain paper. <br /> Size of Parcel S � O Requirements sq. ft. <br /> Public Water (name) Public Sewerage (name) /z. <br /> SUMMARY.OR COMMENTS: . . <br /> 12�d o4 <br /> J• _ I�GI - Ilr..� <br /> On basis of above, I recommend:., Approval Do al Continuance <br /> . Signed . <br /> FOR OFFICE USE ONLY <br /> Report to Planning Standard Paragraph Approval Disapproval Continuance:Q .; <br /> b <br /> Ell 06 06 3/71 11/83 500 <br />