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LAND USE <br /> REF'0 RT <br /> APP <br /> TO Bo completed and Submitted by <br /> Data Issued <br /> ADDRESS U1•A <br /> ArPL.ICANTIS NAM <br /> "OPOSED USE/CH"GE ADORES <br /> In completing the band Use investigation draw all Public Health tactors on the <br /> geyage disposal, water euppliea, etc, exhibit. <br /> area ahouinB.PoPulatioa density, location of ho Where nwilxf ,dirfotdraw a cpleon zap of <br /> piece of plain paper, , „ an attached <br /> Size of Parcel <br /> Requircaents eq. ft. <br /> Public Water (name) <br /> Public Sewerage (name) <br /> SUMMARY OR GUt4�NT9; <br /> 1 <br /> 2. r <br /> r <br /> 3. <br /> L. <br /> On basis ofabove, I recoauaend; Approval penial <br /> Continuance <br /> Signed <br /> FUR OFFICE USE ONLY <br /> Report to Planning Standard Paragraph <br /> Approval Disapproval Continuance a <br /> d— <br /> El' 06 06 3/71 <br /> 11/83 500 <br /> i <br />