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LAND USE, REPORT <br /> APP # t '— G1 •—S <br /> To Be completed and Submitted by <br /> i Date Issued <br /> ADDRESS UPA <br /> APPLICANT'S NAME ADDRESS ' <br /> PROPOSED USE/CfWIGE <br /> In completing the Lard Use investigation draw all Public Health factors on the exhibit. <br /> (i.e.) Sewage disposal, water supplios, 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 /> 77 V <br /> On basis of above, I recommend:.•: Approval _ Denial Continuance <br /> Jzc Signed <br /> FUR OFFICE USE ONLY <br /> Report to Planning Standard Paragraph Approval Disapproval Continuance; <br /> I t <br /> EH 06 06 3/71 11/83 500 <br />