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1JUAL) U6h 1d'A OIIT <br /> a <br /> AFP # <br /> To Be completed and Submitted by <br /> Date Issued <br /> ADDRESS UFA R"I <br /> APPLICANT'S I4AIIE ADDRESS <br /> PROPOSED USE/CHANGE- <br /> In <br /> SE/CHANGEIn 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) /(/ p <br /> SUMMARY.OR COMMENTS: S (f 4' ;&Or <br /> Y _� �' ..� .s .� 1 C � fs �,����� 7i°' •�,.�r ry ,ems�� � �- <br /> On basis of above, I recommend: Approval Denial s '` Continuance <br /> (F <br /> Signed F E <br /> EOR OFk`ICE USE ONLY <br /> Report to Planning Standard Paragraph Approval Disapproval Continuance <br /> Gtb'�J� 6*3-��) <br /> Ole— <br /> q0 LLl <br /> 00 <br /> I,H o6 oG 3/71 �� <br />