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r LAND USE REPORT <br /> APP -77W <br /> TO Be completed and Submitted by <br /> Data Issued <br /> ADDRESS UI-A, C , <br /> APPLICANT'S NAME <br /> AD <br /> PROPOSUSE/Cfi�WGE RESS <br /> ED <br /> In completing the Land Uae investigation draw all Public Health factors on the exhibit <br /> SeVage disposal, water aupplies, etc, <br /> area abo dere neceQaary, draw cos�pleto 'map of <br /> �n8 population density, location of housed, end dirootion, etc„ on an attached <br /> pisco of plain paper, <br /> Sime of Parcel Requirements eq. ft. <br /> Public Water (rte) Public Sewerage (come) <br /> SUMART OR OC)MMENM: <br /> 1 . <br /> 2. r <br /> 3. <br /> 4. <br /> On basia or above, I reco=end: Approval Denial Continuance <br /> Signed <br /> a; <br /> FUR OFFICE USE ONLY <br /> Report to Planning Standard Paragraph Approval 1:1 Disapproval Continuance a <br /> A� -'OL <br /> CZ / Oil <br /> Eh 06 06 3/71 , <br /> 11/83 S00 <br />