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LAND UO'I; RE=PORT <br /> N APP # S gCl-�S <br /> To Be completed and Submitted by <br /> Date Issued <br /> ADDRESS UPA ll�30� ?� r Ajae <br /> APPLICANT'S NARE 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 Requirements sq, ft. <br /> Public Water (name) Public Sewerage (name) <br /> SUMMARY.OR COMMENTS: <br /> 1. <br /> 2. <br /> 3. <br /> Qt AL <br /> On basis of above, I recommend: Approval Denial, Continuance <br /> Signed J ,'� dc'f�` 1', � o,! • ,�i5'�ji <br /> FUR OFFICE USE ONLY <br /> Report to Planning Standard Paragraph Approval Disapproval Continuance <br /> �•„�� Tom. G�,� I . <br /> � 1 <br /> EH 06 06 3/71 11/83 500 <br />