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o ' LAND USE REPORT <br /> APP N n1 5 _W--P 7 ,..,.. .,.. ,. . <br /> To Be completed and Submitted by 3 /;7—Fj�_> <br /> Data Issued <br /> ADDRESS Uk'A <br /> Ar?LICANT'S NAME ADDRESS <br /> PROPOSED USE/CHANGE <br /> In completing the Land USS investigation draw all Public Health factors on the exhibit. <br /> (i.e.) Savage disposal, water supplies, etc. There necessary, dray complete •map of <br /> area showing-Population density, location of housed, wird direction, ate, on an attached <br /> Piece of plain paper. . <br /> Size of Parcel Requirements aq. ft. <br /> Public Water (name) Public Sewerage (name) <br /> SUM RY OR GOMMT3: I <br /> 2 i <br /> 3. <br /> 6. <br /> On baala of above, I recommend: Approval Denial Continuance <br /> Signed <br /> FOR OFFICE USE ONLY <br /> Report to Planning Standard Paragraph Approval Disapproval L1 Continuance a <br /> O � <br /> EH 06 06 3/71 11/83 500 <br />