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LAND USE REPORT <br /> APP <br /> TO Be completed and Submitted by (C - <br /> Data Issued <br /> ADDRESS UTA LZQE , K C-U-LE, <br /> WLICANT'S NAME • PEz Z T, [3 r c M h Nj ADDRESS <br /> PROPOSED USE/CHANCE �s - 7 f 1�R A <br /> In completing the Land Use inyeatigation draw all Public Health factors on the exhibit. <br /> (1•a.) Savage disposal, water supplies, etc• dere BeC603ary, dray <br /> of <br /> area Showing•Population density, location of housed, wind dire tion, a c,, eon te anpattached <br /> piece of plain paper, <br /> Sise of Parcel Requirements eq, ft. <br /> Public Water (name) Public Sewerage (name) <br /> SUWIARr OR 03MMmTS: <br /> 1. <br /> 2. <br /> 3. <br /> L. <br /> On baste of above, I reco=end: Approval Denial Continuance <br /> Signed <br /> FUR OFFICE USE ONLY <br /> Resort to Planning Standard Paragraph Approval 0 Disapproval Contlnuance a <br /> s <br /> s� <br /> ' <br /> 06 3/71 11/83 S00 <br />