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LAND USE REPORT �Q p <br /> APP # <br /> To Be completed and Submitted by <br /> Date Issued <br /> ADDRESS U P A <br /> APPLICANT'S NAME ADDRESS <br /> PROPOSED USE/CHA.NGE <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) Public Sewerage (name) <br /> SUMARY OR 00!'I MT3: <br /> 1. �- <br /> 2. ! r <br /> 3• <br /> On basis of above, I recotrma nd: Approval Denial Continuance <br /> Signed '' \ <br /> FOR OFFICE USE ONLY <br /> Report to Planning Standard Paragraph Approval KDisapproval Continuance 0 <br /> V <br /> 0 <br /> Eh 06 06 3/71 11/83 500 <br />