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LAND USI; REPORT <br /> • APP # <br /> To Be completed and Submitted by <br /> Date Issued <br /> ADDRESS UPA Pei t,,) N cct <br /> APPLICANT'S NAME .¢-7,77� <br /> PROPOSED USE/CHANGE <br /> In completing the band Use investigation draw all Public Health factors on the exhibit. <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 /> � <br /> , 1i6 4"t <br /> Size of Parcel,,L 0 C Requirements sq. ft. <br /> Public Water (name)__ Public Sewerage (name) . <br /> SUMMARY.OR COMMENTS: <br /> 2. �/,� � . <br /> l <br /> 4. <br /> On basis of above, I recommend:.. Approval Denial Continuant <br /> Signed <br /> FUR OFFICE USE ONLY <br /> Report to Planning Standard Paragraph Approval Disapproval Continuance; <br /> EH 06 06 3/71 11/83 500 <br />