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LAND USE REPORT <br /> i <br /> ^ APP # FC �3 <br /> To Be completed and Submitted by <br /> Date Issued <br /> ADDRESS UPA e=,54 sLQ- Y � <br /> APPLICANT'S NAME ADDRESS <br /> PROPOSED USE/CHANGE <br /> In completing the Land 114- investigation draw all Public Health factors on the exhib t. <br /> (i.e.) Sewage disposal, water supplies, 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 ! -7S Requirements sq. ft. <br /> Public Water (name) WCift/N Public Sewerage (name) <br /> SUMMARY.OR COMMENTS: <br /> 2. <br /> 3• <br /> 4. <br /> On basis of above, I recommend: Approval `� Denial Continuance <br /> Signed SOL <br /> FOR OFFICE .USE ONLY <br /> Report to Planning Standard Paragraph Approval Disapproval Continuance <br /> CC4 A-7 <br /> EH 06 06 3/71 11/83 500 <br />