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• O <br /> LAND USE REPORT <br /> APP # aS f7- <br /> To Be completed and Submitted by - <br /> � Date L Issued ' <br /> ADDRESS UrA �� � kv Y "1 <br /> AYeLICANT'S NAME 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 �dl 1 "Requirements sq. ft. '- <br /> Public Water (name) ,r y-t, o—# - Public Sewerage (name) <br /> SUMMARY OR COMIENTS. <br /> r f / <br /> 3 ct <br /> 4. A <br /> On basis of Aove, I recommend: ApprovalD al Continuance <br /> Signed <br /> FOR OFFICE USE ONLY <br /> Report to Planning Standard Paragraph Approval Disapproval Continuance <br /> EH 06 06 3/71 11/83 500 <br />