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• (1) <br /> LAND USE REPORT <br /> APP <br /> TO Be completed and Submitted by <br /> Date Issued <br /> ADDRESS U1'A < �' 'ey7 <br /> Ar P LI CANT'S NAME ' DRESS <br /> PROPOSED USE/CHANGE —t <br /> In completing the 1AW Use investigation draw all Public Health factora on the p of <br /> e� <br /> Sewage disposal, water suppllea, etc. Where neceeaary, draw complete ibit. <br /> 's� <br /> 4"a showing-PoPulstion� density, location of housed, wind dirsotion, <br /> Place of plain paper, etc„ on a attached <br /> Site of Parcel RegairCaenta eq. ft. <br /> Public Water (name) Public Sewerage (name) <br /> SU R 00 O(E1N TS: <br /> 2 r <br /> 3 - <br /> On basis of above, I reco=end : Approval ✓De al Continuance <br /> Signed <br /> FUR OFFICE USE Ot-L LY <br /> Report to Planning Standard Paragraph Approval Disapproval Continuance <br /> Ef' ob Od 3/71 <br /> 11/83 500 <br />