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f ♦ ' <br /> LAND USE, REPORT <br /> APP N Cti t 5 r7 - 3 <br /> To Be completed and Submitted by 71 <br /> Date Issued <br /> ADDRESS UPA t <br /> APPLICANT'S NAME ADDRESS . <br /> PROPOSED USE/CHANGE <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 or Parcel Requirements sq. rt. <br /> Public Water (namo) Public Sewerage (name) <br /> SUMMARY-OR COMMENTS: <br /> p u • ► <br /> 7- <br /> On basis of above, I recommend Approval Denial Continuance C.� atsk <br /> Signed e'`'i2Z <br /> FOR OFFICE USE ONLY <br /> Report to Planning Standard Paragraph -Approval Disapproval Continuance;[� <br /> . 31 <br /> Eli 06 o6 3/71 11183 500 <br />