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LAND USI: REPORT <br /> APP // �Cd-/ <br /> To Be completed and Submitted by <br /> Date Issued <br /> ADDRESS UPA 1 f-ST I 5"I c-c he"t - led C', <br /> APPLICANT'S NAME ADDRESS <br /> PROPOSED USE/CHMIGE <br /> In completing the Land Use investigation draw all Public Health tactors on the exhibit. <br /> (i.e.) Sewage disposal, water supplies, etc. Where necessary, draw complete map or <br /> area showing population density, location or housed, wind direction, etc., on an attached <br /> piece or plain paper. ' <br /> Size or Parcel y_�i_ Requirements sq. rt. <br /> Public Water (name) Public Sewerage (name) <br /> SUMMARY-OR COMMENTS: <br /> 2. <br /> 4 <br /> On basis of above, I recommend:. Approval ', D vial ntinuance <br /> Signed - <br /> SUR OFFICE USE ONLY <br /> Report to Planning Standard Paragraph Approval Disapproval Continuance; .; <br /> Eli 06 06 3/71 11/83 500 <br />