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' cI � <br /> LAND USE REPORT <br /> APP / ►� — f� — f f1 f <br /> To Be coapleted and Submitted by <br /> Data Iasuad <br /> ADDRESS UrA , <br /> A YLI CANT'S NAM ' ADDRESS <br /> PROPOSED USE/CHANGE <br /> In completing the Lard Use inveatigation draw all Public Health tactors on the a(hibit. <br /> Sevage disposal, water auppliea, etc. -Zara neceoaary, draw coaVleta *map of <br /> 1xea showing•population density, location of housed, wird direction, etc„ on an attached <br /> Piece of plain paper. <br /> Size of Parcel RequireManta eq. ft. <br /> Public Water (name) Public Sewerage (tame) <br /> SUMLRZ 0R COMMExT3: <br /> 2. r <br /> 3. <br /> L. <br /> On baele of above, I recommend: Approval Denial Continuance <br /> Signed <br /> r <br /> IR F 777 <br /> FOR OFFICE USE ONLY <br /> Report to Planning Standard Paragraph Approval Disapproval Continuance a <br /> r <br /> E.H 06 O6 3/71 <br /> 11/83 SOO <br />