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� 1 <br /> LAID USE r{,I'UHT <br /> ` AFP #/Opf�' 7 <br /> To Be completed and Submitted by <br /> / Date Issued <br /> ADDRESS UPA <br /> APPLICANT'S NAME .�,f ADDRESS <br /> PROPOSED USE/CHANGE <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. qVSize of Farcel 20 . Requirements sq. ft. `�— <br /> Public Water (name) >--j Public Sewerage (name) <br /> SUMMARY OR COMMENTS: / <br /> On basis of above, I recommend: Approval a 'al Continuance <br /> Signed <br /> FOR OFFICE USE ONLY <br /> Report to Planning Standard Paragraptt Approval disapproval Continuance t� <br /> I� <br /> EH 06 06 3/71 <br /> CA, <br /> i <br />