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cls <br /> LAND USE REPORT <br /> APP <br /> To Be completed and Submitted by "7 <br /> Data Issued <br /> ADDRESS U r A �. � 1 z ,,,,,�. <br /> A'?U CANT'S NAME ADDRESS <br /> PROPOSES) USE/CRANCE <br /> In completing the Land Use investigation draw all Public Health factors on the exhibit. <br /> (i.e'.) SeVage disposal, water supplies, etc. W�iere necessary, draw complete '�aap of <br /> a"a shOwing-populationdensity, location of housed, wind direction, etc„ on an attached <br /> piece of plain paper. <br /> Size of Parcel Requirements aq. ft. <br /> Public Water (name) Public Sewerage (name) <br /> SUMARt OR OOE Wn: <br /> 2. r <br /> 3. <br /> On basia of above, I recoamiend• Approval ge vial Continuance <br /> Signed <br /> FUR OFFICE USE Ot+LY <br /> Report to Planning Standard Paragraph Approval Disapproval Continuance a <br /> I. SO <br /> Eh 06 06 3/71 11/83 500 <br />