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�• LAND USE REPORT <br /> APP # <br /> To Be completed and Submitted by <br /> Date Issued <br /> ADDRESS UPAD <br /> G U S l u e I I t �o L;k <br /> APPLICANT'S NA14E J `-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 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. <br /> z. 3. ( <br /> 3. 1 a I�(• <br /> L. <br /> On basis of above, I recommend:, Approval `` e Continuance <br /> Signed1 <br /> FOR OFFICE USE ONLY <br /> Report to Planing Standard Paragraph Approval Disapproval Continuance. . <br /> T"C�f ."t i��Lpr� <br /> CV"'& S�' -"-z) <br /> c <br /> EH 06 06 3/ ) r� - , �� 11/�` <br />