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LA14D USE REI'UHT <br /> AFP # <br /> To Be completed and Submitted by ----- � <br /> r <br /> / <br /> Date Issued <br /> ADDRESS UrA <br /> APPLICANT'S NAME r�� ,�' Z &' ADDRESS <br /> PROPOSED USE/CHAP;GE <br /> In 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 OR COMMENTS: <br /> 2. <br /> 13.. <br /> 4• <br /> On basis of above, I recommend: Approval Denial Continuance <br /> Signed (l��ca,�.k"" <br /> FUR OFFICE USE ONLY <br /> Report to Planning Standard Paragraptr Approval Disapproval Continuance Q <br /> P <br /> EH o6 o6 3/71 <br /> i <br />