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LANA U'Sl, REPORT <br /> APA �a <br /> • IS <br /> .. To Be completed and Submitted by � <br /> Date Issued <br /> ADDRESS UPA r�S� Lwvnr <br /> APPLICANTIS NAME <br /> PROP051::D USE/CH CC!, �1� 0'. <br /> 5 Q °'!!� ADD=. S � p(� w 19 <br /> Shy <br /> (In completing the Land Use invostiCation draw al], Public Hoa�.th Factors - <br /> ai•a'•y Sewage dispoaal, water suppliou, eLe. here on the <br /> arca shaxittC l�Pw•ation density., necessary., map or t. <br /> location of housed ' draw complete map or <br /> Piece of plain paper. ' . , wind direction etc <br /> „ en an attached <br /> Size of Parcel <br /> �c rrs Requirements sq., ft. <br /> Public {Muter (name) . ' a <br /> SUM AXT.ORMMI'NTS• Public SewaraCe (name) o <br /> . I <br /> Z• T-t <br /> "4 le <br /> G ir 1A <br /> VQ <br /> On basis of Above, I recommend:., Approval �+ Denial . ' . <br /> Continuance <br /> Signed <br /> FCR OFFICE USE ONLY ' <br /> Report to PlannLng Standard Pia u h . <br /> P Approval Disapproval Continuance- . <br /> EH 06 06 3/71 . <br /> 11183 500 <br />