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LAND USE REPORT <br /> 'y APP N ]�"� S �1 �� (;; �, •� <br /> To Be completed and Submitted by ^� 10 <br /> Date Issued <br /> ADDRESS UPA _ f S l 3 r y C' I lU �,'�c� y►-Iz'4 <br /> APPLICANT'S NAME ADDRESS . <br /> PROPOSED USE/CHAIGE <br /> In completing the Land 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, wird 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 /> dAf <br /> On basis of above, I recommerd:.� Approval Denial Continuance _ <br /> Signed <br /> FOR OFFICE USE ONLY <br /> Report to Planning Standard Paragraph Approval Disapproval Continuance' <br /> EH 06 06 3/71 11/83 500 <br />