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LA:7D USW D7PORT <br /> p <br /> To Be completed and Submitted by <br /> __. .. .. Date Issued <br /> ADDF ,SS UrA �• G( G " �- v" <br /> AD <br /> APPLICANT'S NAME ,� DRESS <br /> PROPOSED USE/CHANGE ` <br /> In completing the Land 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. 1I <br /> Size of Parcel Requirements sq. ft. <br /> Public Sewerage (name) e ecl 1�-Y � <br /> Public Water (name) 2:-,,., ' <br /> SUMMARY OR COM14ENTS: <br /> 7- <br /> On basis of above, I recommend: Approval Denial Continuance <br /> Signed <br /> FOR OFFICE USE ONLY <br /> Report to Planning Standard Paragraph Approval Disapproval Continuance <br /> eu.(-X V <br /> Dc <br /> 06 06 3 71 <br /> i <br />