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LAND USE. REPORT <br /> APP <br /> To Be completed and Submitted by <br /> Date Issued <br /> lL <br /> -2- <br /> ADDRESS <br /> ADDRESS UPA <br /> APPLICANT'S NAME ADDRESS <br /> PROPOSED USE/CHANCE <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 Requirements sq, ft. <br /> Public Water (name) Public Sewerage (name) <br /> SUMMARY.OR COMMENTS: <br /> I. C O- s i i �' ( G� c'� C�E �► t., ��� �,� � .. <br /> 2- a vv ui�#leu wet ' <br /> On basis of above, I recommend:.± Approval Denial Cont uanee <br /> C S Signed ___L <br /> r <br /> FOR OFFICE USE ONLY <br /> Report to Planning Standard Paragraph ApprovalDisapproval Continuance;Q <br /> 41 <br /> E{I 06 06 3/71 11/83 500 <br />