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LAND USE, REPORT <br /> APP N �1���0-(� Zw -(It) -A <br /> l <br /> To Be completed and Submitted by <br /> Date Issued <br /> ADDRESS UPA �C�1 U f (� cict L a.� <br /> APPLICANT'S 11AME 7774gLe777171ADDRGSs <br /> PROPOSED USE/PCHANGI;�� <br /> ....� � , �wx f�Yi�� /�< 9�/ .4«��� x <br /> In completing the Land Use investition�draw al Public Health tactors on e a <br /> (i.e.) Sewage disposal, water supplies, et-c. Where necessary, draw complete map of <br /> area showing population density, location of housed, wind dircction, etc„ on an attached <br /> piece of plain paper. <br /> Size of Parcel 1/7, 4 Requirements sq. ft. <br /> Public Water (name) Public Sewerage (name) <br /> SUMMARY.OR 00M10ITS: <br /> 2. <br /> 3. <br /> 4. <br /> On basis of above, I recommend:. Approval �' enial Continuance <br /> Signed �c,. <br /> FOR OFFICE USE ONLY <br /> Report to Planning Standard Paragraph Approval Disapproval Continuance; <br /> El{ 06 06 3/71 11/83 500 <br />