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To Be completed and Submitted by <br /> Date Issued <br /> ADDRESS UPA <br /> APPLICANT'S NAME ADDRESS <br /> PROPOSED USE/CHANGE <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 complte 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 /> SUMKARY OR OOMMENTS: <br /> 1. <br /> Z. <br /> 3- <br /> 1� . <br /> On basis of above, I recommend: Approval Denial Continuance <br /> Signed <br /> FUR OFFICE USE ONLY <br /> Report to Planning Standard Paragraph Approval 0 Disapproval Continuance a <br /> Eli 06 06 3/71 <br />