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LAND USE REPORT <br /> 0 17 <br /> To Be completed and Submitted by / <br /> �y Date Issued <br /> ADDRESS UPA <br /> APPLICANT'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 1 �j«-'" s xoacf-f <br /> Requirements sq. ft. <br /> Public Water (name) r f Public Sewerage (name) <br /> SU101ARY OR COMMENTS. <br /> 1. ,V O. f • <br /> 2. <br /> 3• <br /> 4. <br /> On basis of above, I recommend: Approval enial Contin nce <br /> Signed A� ;P— <br /> FOR OFFICE USE ONLY <br /> Report to Planning Standard Paragraph Approval dDisapproval Continuance Q <br /> EH o6 06 3/71 <br />