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LAND U61. 1t1:PORT �/ J <br /> e APP Z- <br /> To Be completed and Submitted by <br /> Date Issued <br /> ADDRESS UPA ��C� �' S y �fi-�; "Z <br /> APPLICANT'S NAME ADRESS <br /> PROPOSED USE/CHVJGZ <br /> In completing the Lard 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) 1- Public Sewerage (name) <br /> SUMMARY.OR COMMENTS: ,j/ �?41 <br /> l. , f 2 <br /> 2. V + Cl <br /> /.7 5 / <br /> 3• d t S / , ,,� <br /> On basis of above, I recommend: Approval , --"Denial Continuance <br /> Signed <br /> MR OFrZCE USE ONLY <br /> Report to Planning Standard Paragraph Approval Disapproval Continuance: <br /> L <br /> a Q <br />