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' LAND IM REPORT <br /> APP # <br /> To Be completed and Submitted by <br /> Date Issued <br /> ADDRESS UPA )--75 2- <br /> APPLICANT'S NAME - ADDRESS <br /> PROPOSED USE/CHANGE <br /> In completing the Land Use 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 att ched <br /> piece of plain paper. ' <br /> Size of Parcel Requirements sq. ft. <br /> Public Water (name) Public Sewerage (name) <br /> SUMMARY-OR OOMMENTS: <br /> 1. f" " <br /> 2. <br /> ar <br /> 3. <br /> 4. <br /> On basis of above, I recommend:. ApprovalDenial Continuance <br /> Signed —A.., "M� "" <br /> FOR OFFICE USE ONLY <br /> Report to Planning Standard Paragraph Approval Disapproval Continuance,c] <br /> EH 06 06 3/71 11/83 500 <br />