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(1) <br /> LAND USE REPORT <br /> APP # <br /> To Be completed and Submitted by <br /> Date Issued <br /> ADDRESS UPA Z- � — <br /> APPLICANT'S NAME ADO ESS <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 completezaap of <br /> area shoring 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 /> SUMMARY OR 00M4E2J TS: <br /> 2. <br /> 3- <br /> 4• / <br /> On basis of above, I recommend : Approval Denial Continuance <br /> Signed <br /> FOR OFFICE USE ONLY <br /> Report to Planning Standard Paragraph Approval Disapproval Continuance a <br /> _r� <br /> EH 06 06 3/71 11/83 500 <br />