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y� <br /> TAND U SL REPORT <br /> APP # <br /> To Be completed and Submitted by <br /> I II Date Issued <br /> ADDRESS UPA (11 ll dr VL, Sl Lt i ti»t (L�r 13 o /L G1 ►yv✓ ���L o i <br /> APPLICANT'S NAME ADDRESS <br /> PROPOSED USE/CIWIGE <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 /> 3. 1 .Z Li:,IIiAll <br /> SS <br /> On basis of above, I recommend: Approval Denial Continuance <br /> Signed <br /> MR OFFICE USE ONLY <br /> Report to Planning Standard Paragraph Approval Disapproval � Continuance; <br /> EH 06 06 3/71 \3I 11/83 500 <br />