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cls <br /> LAND USE REPORT <br /> APP <br /> To Be completed and Submitted by <br /> Date Issued <br /> ADDRESS UPA fa y <br /> Al'P LI CANT'S NAME ADDRESS <br /> PROPOSED USE/CHANCE <br /> In completing the Land Use investigation draw all Public Health factors on the exhibit. <br /> (i.e;) SeWage disposal, water supplles, etc. Where necessary, draw complete 'ntap of <br /> area showing-population density, location of housed, wind direction, etc„ on an attached <br /> Piece of plain paper. <br /> Size of Parcel Requirements sq. ft. <br /> Public Water (name) Public Sewerage (name) <br /> SUMARr OR O0?0WT3: <br /> 1 <br /> 2. <br /> 3. 9 ; <br /> On basis of above, I recoamend• Approval L/ D trial Continuance <br /> Signed �✓ <br /> J <br /> FOR OFFICE USE ONLY <br /> Report to PlaC 1. C. " L_nning Standard Paragraph Approval Disapproval Continuance a <br /> (Go1 ) <br /> �S,� (60.-A- aj,,-k <br /> 3 Y3 � * 124) <br /> 82 V_� <br /> Eh 06 06 3/71 11/83 500 <br />