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Y ljudu Ubn REPORT <br /> APP <br /> To Be completed and Submitted by �� m -�q <br /> Date Issued <br /> ADDRESS UPA <�, L �� -� c4 !� <br /> APPLICANT'S I4AIIE ADDRES <br /> PROPOSED USE/CHANGE- <br /> In <br /> SE/CHANGEIn completing the Land Use investigation draw all Public Health factors on the exhibit. <br /> (i.e.) Sewage disposal, water supplies, 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-011 COMMENTS: <br /> 2. '' p' .c ,G:,t. q� /ls.l ' <br /> 3. <br /> On basis of above, I recommend: . Approval Depial al Continuance <br /> Signed <br /> FUR OFFICE USE ONLY <br /> Report to Planning Standard Paragraph Approval Disapproval Continuance;[ <br /> 14 <br /> / 7 �y <br /> Ell 06 06 3/"11 11/83 500 <br />