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, <br /> LAND USE REPORT Al <br /> ' APP N — Cl® - <br /> To Be completed and Submitted by C�_ <br /> Date Issued <br /> ADDRESS UPA <br /> APPLICANT'S NAME Com, 5 <br /> ADDRESS 16-701 r �'lii'DOnIII 0,oj <br /> PROPOSED USE/CHANGE erre cY .�_o r40 s <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 `I q3 �iw Requirements sq. ft. <br /> Public Water (name) �!�( Q,Q Public Sewerage (name) <br /> SUMMARY.OR OOMMENTS: .. <br /> 2. <br /> 3. <br /> On basis of above, I recommend:.t Approval ✓ Denial Continuance <br /> . Signed <br /> FOR OFFICE USE ONLY <br /> Report to Plann.Lng Standard Paragraph -Approval Disapproval Continuance'El <br /> EH 06 06 3/71 11/83 500 <br />