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JJijJU Ub", RE'PORT <br /> i <br /> APP # L a Sq `i a- DCS ` <br /> To Be completed and Submitted by <br /> Date Issued <br /> ADDRESS UPA 15 M 0 (fie <br /> APPLICANT'S NA14E ADDRESS <br /> PROPOSED USE/CHANGE <br /> In completing the Land 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 /> Size of Parcel Requirements sq. ft. <br /> Public Water (name)�/'�� A. 6,M 12_Public Sewerage (name) <br /> SUMARY.OR OM ENTS: <br /> 2. - <br /> � w <br /> 3• <br /> On basis of recommend: -1 above, unend: -�._...,.�.�,�.•.._ .__.._. . _-____._._...._�. <br /> ' u Approval �Denial +Continuance <br /> Signed -� �L�Ti/� <br /> FUR OFFICE USE ONLY <br /> Report to Planning Standard Paragraph Approval Disapproval Continuance; <br /> Ell 06 06 3/71 11/83 500 <br />