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1JUJU UJI; 1{!SI'(11t'1' <br /> APP lJ M .i <br /> To Be completed and Submitted by <br /> Date Issued <br /> ADDRESS UPA _2 75- S C_ s �,,, 7 r <br /> APPLICANT'S IJAII ADDRESS <br /> PROPOSED USE/CRAIJGE, <br /> In completing the Lard Use investigation draw all Public Health facto?s'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 001 MENTS <br /> 1. �7) <br /> 2. <br /> 3• <br /> On basis of above, I recommend:.. Approval D nia Continuance <br /> Signed <br /> FOR OFZICE USE ONLY <br /> Report to Planning Standard Paragraph ApprovalP�fDisapproval Continuance; .' <br /> l <br /> 31 <br /> Lif 06 06 3/71 11/83 500 <br />