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LAND USL REPORT <br /> APP N s L-{ -Ct v -Y A- <br /> To Be completed and Submitted by <br /> Date Issued <br /> ADDRESS UPA c= Z' y K�• t ( -,L- <br /> APPLICANT'S 14AME ADDRESS <br /> PROPOSED USE/CHANGE <br /> In completing the Lary] Use investigation draw all Public Health factors on the exhibit. <br /> (i.e'.) Sewage disposal, water supplios, 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) s 19 Public Sewerage (name) .,, C <br /> SUMMARY-OR COMMENTS: .. <br /> 2. P s r <br /> On basis of above, I recommend:- Approval ! Denial Continuance <br /> Signed •�- / " ,/r_ <br /> FUR OFFICE USE ONLY <br /> Report to PlamLng Standard Paragraph Approval Disapproval Continuance;CD [ <br /> EH 06 06 3/71 11/83 500 <br />