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1jiNU Ubr: REPORT <br /> -- <br /> «t .... APP // 11� SJ <br /> To Be completed and Submitted by <br /> Date Issued <br /> ADDRESS UPA <br /> APPLICANT'S NAME AbbRESS — <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)_ A/pA_ho Public Sewerage (name) <br /> SUMMARY-OR COMMENTS: <br /> v <br /> r <br /> /r Own basis of above, I recommend: . Approval to� Denial Continuance <br /> 4o ve f��/ � )4 2 Signed � <br /> FOR OFFICE USE ONLY <br /> Report to Planning standard Paragraph Approval Disapproval Continuance;Q . ; <br /> C <br /> S � ' <br /> J�L <br /> o0 <br /> Eli 06 06 3/71 11/83 500 <br />