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LAND USI: RrTORT <br /> • APP // <br /> To Be completed and Submitted by f- /—U <br /> Date Issued <br /> ADDRESS UPA <br /> APPLICAN'T'S-14 A- M <br /> ADDRESS <br /> PROPOSED USE/CHMICE <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, wind direction„ etc„ on an attached <br /> piece of plain paper. <br /> Size of Parcel 1C. jo`;?,If 10 Requirements sq, ft. <br /> Public Water (name)= Public Sewerage (name) 4 ( 4/,-_/) <br /> SUMMARY.OR COMMENTS: <br /> O <br /> 2. <br /> 3• <br /> On basis of above, I recommend:.> Approval x' Denial Continuance <br /> Signed <br /> FOR OFFICE USE ONLY <br /> Report to Plann.Lng Standard Paragraph -Approval Disapproval Continuance' Q <br /> 5 ! 1 <br /> EH 06 06 3/71 11/83 500 <br />