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t IJuJLI UJIi REPORT <br /> APP /{ ✓ -( <br /> To Be completed and Submitted by <br /> -� Date Issued <br /> ADDRESS UPA --'4- <br /> APPLICANT'S <br /> '4 APPLICANT'S NAM[: ADDRESS <br /> PROPOSED USE/CRAPIGE <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 COMMENTS,_ <br /> 1. 3 _11 <br /> 2. <br /> 3. 5 <br /> On basis of above, I recommend: Approval De 'al ,�_ Continuance <br /> Signed . <br /> MR OFFICE USE ONLY <br /> Report to Planning Standard Paragraph Approval Disapproval Continuance <br /> (all <br /> 7, <br /> m o6 06 3/71 11/83 500 <br />