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il I1 C:: :Jr 11Q11T <br /> I}- <br /> . � <br /> AFP # <br /> To Be completed and Submitted by <br /> Date Issued <br /> ADDRESS UYA � �iG- eE',C: <br /> APPLICANT'S NAME 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 CONSENTS: <br /> 3 <br /> On basis of above, I recommend: Approval �l Continuance <br /> Signed <br /> FIR OFFICE USE ONLY <br /> Report to Planning Standard Paragraph Approval a Disapproval Continuance a <br /> Eii o6 o6 3/71 <br /> l <br />