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LAND USE REPORT ( l) <br /> APP <br /> To Be completed and Submitted by <br /> Date Issued <br /> ADDRESS U1-A `�Do(P <br /> AP?LICANTIS NAME <br /> PROPOSUSE/CHANGE —ADD <br /> ED <br /> In conpleting the band Use lnvastigation draw all Public Health factors on the exhibit <br /> Sewage disposal, water eu lies etc, <br /> area eho PP Where necessary, draw caoplete -asap of <br /> •population, density, location of housed, wind direotioo, atc <br /> Piece of plain paper, „ on an attached <br /> Sisa of Parcel Requirement3 aq. ft. <br /> Public Water (name) C S /1.. <br /> Public Sewerage (tua►e) .21 <br /> SUKURZ OR OC)14MMT3: <br /> 2, <br /> 4 iy s� r� � ✓ � /n'7 �. r �E <br /> On balls of above, I recommend: Approval <br /> , Denial Continuance > � <br /> Signed <br /> FOR OFFICE USE Ota <br /> Report to Planning Standard Paragraph Approval LY Disapproval Continuance <br /> Efi ob 06 3/71 <br /> 11/83 SOO <br />