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idLIA1 UJl'. JtM'0j(*f <br /> 1 — <br /> AFP �} � S PV '{P�' <br /> To Be completed and Submitted by 3 --2- 5- k, " <br /> Date Issued <br /> ADDRESS UPA ),71 �- N Lcw <br /> APPLICANT'S NAME ADDRESS <br /> PROPOSED USE/CHANOI3 <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) Public Sewerage (name) <br /> SUMMARY.OR CCIMWNTS: <br /> 2.— �n -..�-�,-�; <br /> On basis of above, I recommend:.. Approval ZDee al Continuance <br /> Signed <br /> FOR OFFICE USE ONLY <br /> Report to Planning Standard Paragraph -Approval M Disapproval Continuance:[ . <br /> 43>1 <br /> Eli 06 06 3/71 11/83 500 <br />