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LAND USE REPORT <br /> .; A, C a <br /> To Be completed and Submitted by <br /> Date Issued <br /> ADDRESS UI-A <br /> APPLICANT'S IIAI (j ! ADDRESS <br /> PROPOSED USE/CHANGE - LS _ <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 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 Requirements sq. ft. <br /> Public Water (name) Public Sewerage (name) <br /> SUMMARY OR COMMENTS: <br /> 1. 40)1 ga 0 e /_a� / ��!(lJ�if"��y.�,i,„�.�P� y�� .2 ';7.77 <br /> 6-6 / 4� <br /> On basis of agove, I re ommend: Approval Denial Continuance _ / <br /> Signed � ��-� ��( //) 57 Fr9 <br /> FOR OFFICE USE ONLY <br /> Report to Planning Standard Paragraph Approval Disapproval p Continuance O <br /> cH uo U6 31Y i <br />