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LAND USE UPORT <br /> • APP <br /> To Be completed and Submitted by <br /> Date Issued <br /> ADDRESS UPA 4-2- <br /> APPLICANT'S NAME - ADDRESS <br /> PROPOSED USE/CFIMIGE <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 or housed, wind direction, etc,, on an attached <br /> piece or plain paper. <br /> Size or Parcel Requirements sq. rt. <br /> Public Water (name) Public Sewerage (name) <br /> SUMMARY.OR COMMENTS: <br /> 1. <br /> 2. <br /> On basis of above.. I recommend:. Approval Denial Continuance <br /> Signed <br /> MR OFFICE USE ONLY <br /> Report to PlannLng Standard Paragraph -Approval Disapproval Continuance'Q <br /> .. _. •/2� � , 9-�o � � (c� r►•►-Lc� ;Lar <br /> lt�- � ort,r�,...-.� <br /> EI{ 06 06 3/71 ��ld 11/83 500 <br /> Y <br />