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MOO USr: R1:PORT <br /> AFP / <br /> To Be completed and Submitted by 1�z <br /> Date Issued <br /> ADDRESS UPA / ,,.<,' / lam. I_ ✓�v'� C.i <br /> APPLICANT'S 14AIIE 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) Public Sewerage (name) <br /> SUMMARY.OR COMMENTS: <br /> 1. <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 Disapproval ContinuanceEJ <br /> a o6 06 3/71 11/83 500 <br />