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LAM11 US-- REPORT <br /> AT? # <br /> To Be completed and Submitted by <br /> /.., Date Issued <br /> ADDRESS UrA ^coq <br /> A?PLICANT'S NAME ADDRESS <br /> PROPOSLD USE/CHANCE <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 Q <br /> en.-, ✓!J /�� C s �i�`�`� ��✓/c2 Q�t.t c..k�. vQ a_e� <br /> U J <br /> his' S-T <br /> _Y <br /> �M.r--✓� a �, � � est O't � /1^�e�.- �/"� M..�d� <br /> U <br /> v <br /> Ex 06 06 3/71 <br />