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LAND USE; REPORT <br /> ' APP yn J Z <br /> To Be completed and Submitted by /D � (�"'-��• <br /> Date Issued <br /> ADDRESS UPA lU -70 f1 r_ l -Y Gt <br /> APPLICANT'S 14AME ADDRESS . <br /> PROPOSED USE/CHA11GE ' <br /> In completing the Land Use investigation draw all Public Health factors on the exhibit. <br /> (i.0.) Sewage disposal, water supplios, etc. Where necessary, draw complete map of <br /> area showing population density, location of housed, wired direction, etc„ on an attached <br /> piece of plain paper. <br /> Size of Parcel `I -% s Requirements sq. ft. <br /> Public Water (name) Public Sewerage (name) <br /> SUMMARY.Ort COMMENTS: .`. <br /> 1. <br /> On basis of above, I recommend:., Approval D vial Continuance <br /> .D 1 Signed zA <br /> FUR OFFICE USE ONLY <br /> Report to Planning Standard Paragraph Approval Disapproval Continuance*.[:].; <br /> 16 <br /> � =l Vii. �� �• �� �s <br /> EH 06 06 3/71 11/83 500 <br />