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LAND USE REPORT <br /> APP # <br /> To Be completed and Submitted by <br /> Date Issued <br /> ADDRESS UPA +_ (c ' r - II /-1 Li - .; <br /> APPLICANT'S NAME ADDRESS — <br /> PROPOSED USE/CHAIGE <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, wired 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: <br /> 1. <br /> 2. -•- <br /> 3. <br /> 4. <br /> On basis of above, I recommend:.- Approval Denial Continuance <br /> Signed <br /> FUR OFFICE USE ONLY <br /> Report to Planning Standard Paragraph Approval Disapproval Continuance: <br /> 1 <br /> EH 06 06 3/71 11/83 500 <br />