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-..AND US-z P.M.cnaT <br /> / AF? ## L2:�U- <br /> To <br /> Be completed and Submitted by <br /> Date Issued <br /> / <br /> ADDRESS UYA ���`- / '� 'c >'`C ; �. <br /> APPLICANT'S NAME � �_ . ?� C j- '�'� 1" y/ ADDRESS <br /> PROPOSED USE/CHANCE <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 complgte map of <br /> area showing population density, location of housed, wind direction, etc„ on an attached <br /> piece of plain paper. p <br /> Size of Parcel / O SIX", Requirements sq. ft. <br /> Public Water (name) Public Sewerage (name) <br /> SUMMARY OR COMMENTS: <br /> 2. i Cis Yu ` <br /> i <br /> On basis of above, I reco , nd: Approval ./ Denial Continuance <br /> Signed �L <br /> "s <br /> CP• �`.;L"`�` ✓r'� FUR 0 FFIM USE ONLY <br /> port to Planning Standard Paragraph Approval Disapproval Continuance Q <br /> 00 <br /> 1. esu Aii u /Lc v� Y/�✓�c K,e c yS lAd <br /> z4 <br /> fZ:7ce, .CY "o <br /> 1-7 <br /> tA-� <br /> EH 06 ob Ala 3/7/1, ems, <br /> v G r � �`�� ,vi � � !'l� '� dl���1 __/_�!"�""'" /� ��7i}./-.-a�M '✓ld 2 G�,,hi��fA�+�y,.� <br /> 64 <br />