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LAND USE REPORT <br /> APP # S Jvq— � 7 ` <br /> To Be completed and Submitted by <br /> Date Issued <br /> ADDRESS UPA 1,/0h `( hXIAd4 <br /> APPLICANT'S 14AME ADDRESS <br /> PROPOSED USE/CHANGE <br /> In completing the Land 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 _ %ejRequirements sq. ft. <br /> Public Water (name) Public Sewerage (name) <br /> SUMMARY-OR COMMENTS: <br /> 1. <br /> 2. j " <br /> 2,0 <br /> Un basi of above, Y recommend::: Approval ✓ Denial Continuance <br /> 4 Signed o �ti 6�1, .• <br /> FOR OFFICE USE ONLY <br /> Report to Planning Standard Paragraph Approval Disapproval p Continuance Q <br /> 3' 41- <br /> EH o6 06 3171 11/83 500 <br />