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• LAND U;;r; iiF,PUiiT <br />APP // Sff JP117y°l <br />To Be completed and Submitted by /� —/0T�/H `� <br />Date Issued <br />In completing the Lard 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 <br />Requirements sq. ft. <br />Public Water (name) Public Sewerage (name) <br />SUMMARY OR COMMENTS: <br />2. 2. <br />3. <br />4. <br />On basis of above, I recommend: Approval V Denial Continuance <br />Signed <br />FOR OFFICE USE ONLY <br />Report to Planning Standard Paragraptr Approval Disapproval p Continuance Q <br />,{� ���1 �- /,rte /}Gwtn o�,-� G�✓/cwt . %�i�+--< . <br />EH o6 06 3/71 <br />