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1.J�ftU UJr; I�L.Y(11t'1' <br /> AFP # <br /> To Be completed and Submitted by <br /> - !l Date Issued <br /> ADDRESS UPA FO 5 Nw <br /> APPLICANT'S NAME _ADDRESS <br /> PROPOSED USE/CHANGE <br /> In completing the Lard Use investigation draw all Public Health factors on the exhibit. <br /> ( ..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. ( L 6j-_ <br /> Size of Parcel s Requirements sq. ft. <br /> Public Water (name) j ;� �_,l� ��( public Sewerage (name)_je <br /> SUMMARY-OR rOOMMENTS: f S <br /> 2. <br /> 3. <br /> i <br /> On basis of above, I recommend: Approval `Denial w W Continuance <br /> Signed 1 <br /> FOR OFFICE USE ONLY <br /> Report to Planning Standard Paragraph Approval rJ Disapproval Continuance;[ . <br /> �-1 <br /> Eli 06 06 3/71 11/83 500 <br />