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idudU u0n lihilulti' <br /> APP # lel - Fq-(0 <br /> To Be completed and Submitted by <br /> Date Issued <br /> ADDRESS UPA <br /> APPLICANT'S NAM ADDRESS <br /> PROPOSED USE/CHANGE <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)�jJpf',Q/ ,,YAC )�y Public Sewerage (name) <br /> SUMMARY.OR OOMMLNTS: �7G��,, /)i S� �• ,�,� <br /> 1. l ' 44 2 ? JJ <br /> 2. <br /> 3• <br /> On basis of above, I recommend: . Approval Denial Continuance <br /> Signed <br /> FUR OFFICE USE ONLY <br /> Report to Planning Standard Paragraph 'Approval isapproval Continuance:Q <br /> 3a <br /> � a <br /> Ell 06 06 3/71 11/83 500 <br />