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LAND USE: REPORT <br /> APP <br /> To Be completed and Submitted by z7Z <br /> Date Issued <br /> ADDRESS UPA IT <br /> m it <br /> A.PP LI CANT'S NAME UADDRESS <br /> PROPOSED USE/CHANCE <br /> In completing the Land Use inve3tigation draw all Public Health factors on the exhibit. <br /> Sevage disposal, water auppliea, etc. Where neceaaary, draw complete *map of <br /> area showing-populatio n density, location of houaed, wird direction, etc, an an attached <br /> Piece of plain paper. <br /> Size of Parcel Requirements eq. ft. <br /> Public Water (name) Public Sewerage (name) <br /> SUl4iARZ OR 00?QENT3: <br /> 1. <br /> 2. <br /> 3. <br /> On basia of above, I recommend: Approval D vial Continuance <br /> Signed <br /> FUR OFFICE U-SE ONLY <br /> Report to Planning Standard Paragraph Approval Disapproval Cont1ruance a <br /> Ef' 06 06 3/71 11/83 500 <br />