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LAND USI: REPORT pg4C' �l <br /> _. APP C/o <br /> To Be completed and Submitted by 2-5--9 ,j <br /> Date Issued <br /> ADDRESS UPA <br /> APPLICANT'S NAME V ADDRESS <br /> PROPOSED USE/CHANGE <br /> In completing the Land Use investigation draw all Public Health tactors on the exhibit. <br /> (i.e.) Sewage disposal, water supplios, 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 /> SUMMARY.OR COMMENTS• �"�. e xLo <br /> ► 5 'i'i,� c.tJ / /, 2 s T <br /> 1-01 <br /> X! <br /> On basis of above %/; <br /> , I recommend:.> Approvals. <br /> L—Beaial _. Continuance _ • ���� �.� <br /> Signed <br /> FUR OFFICE USE ONLY <br /> Report to Planning Standard Paragraph Approval Disapproval Continuance' <br /> IEH 06 06 3/71 – C.. <br /> lam-• p. �$� , 11/83 500 <br />