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' r To Be completed and Submitted by <br /> /� Date Issued <br /> ADDRESS UPA gy-'o/ r <br /> APPLICANT'S NAME ADDSLtSS <br /> PROPOSED USE/CWiGE <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) Alezve Public Sewerage (name) <br /> SUMMARY OR COMMENTS: t <br /> 1Ute' <br /> �• 7 <br /> On basis of above recommend: Approval � Denial Continuance ' ry <br /> rya 1 - <br /> Signed <br /> F0 OFFICE USE ONLY <br /> Report to Planning Standard Paragraph Approval 0 Disapproval Continuance a <br /> y7 <br /> EH 06 06 3/71 <br />