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� LAND USI; RTPORT <br /> APP V <br /> To Be completed and Submitted by 10 <br /> Date Issued <br /> ADDRESS UPA — �•b r �, d�.� . <br /> APPLICANT'S NAME ADDRESS . <br /> PROPOSED USE/CHAPIGE <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 completo 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 /> ag <br /> 2. ^ <br /> r.4 <br /> On basis of above, I recommend:.. Approval Denial Continuance <br /> Signed <br /> FOR OFFICE USE ONLY <br /> Report to Planning Standard Paragraph -Approval Disapproval Continuance,Q <br /> Eli 06 06 3/71 11/83 500 <br />