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• LAND USE. UPORT <br />`• APP <br /> To Be completed and Submitted by <br /> Date Issued <br /> ADDRESS UPA S 8�i �- d- 5 (- Vo Q-e- 1 <br /> APPLICANT'S NAME/., ��' �' ADDRESS.?S,�9o<z�, �1eyE,c-:f- 9r_&,?a <br /> PROPOSED USE/CHANGE <br /> In completing the Lard Use investigation draw all Public Health factors on the exhibit. <br /> (i.e.) Sewage disposal, water supplioc, 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. ' 9a<<s /=i•�•�9� <br /> Size of Parcell .i. rJr° �!_'�_ J Requirements sq. ft. <br /> Public Water (nano) .r�y9�-E4/�,� Public Sewerage (name) <br /> SUMMARY.OR ODMMENTS: . <br /> 2. <br /> On basis of above, I recommend:. Approval _ Denial Continuance <br /> . Signed <br /> FOR OFFICE USE ONLY <br /> Report to Planning Standard Paragraph 'Approval Disapproval Continuance' .; <br /> El{ 06 06 3/71 11/83 500 <br />