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1AfJU USt" 1tl:PUitT <br /> AFP #�� ��- I �-/�� <br /> To Be completed and Submitted by <br /> Date Issued <br /> ADDRESS UPA <br /> APPLICANT'S NAMt; 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 COMMENTS: <br /> 1. <br /> 2. <br /> 3. <br /> u. <br /> On basis of above, I recommend Approval Denial Continuance <br /> Signed <br /> FUR OFFICE USE ONLY <br /> Report to Planning Standard Paragraph Approval ElDisapproval Continuance: _ <br /> . C6 <br /> L li 06 06 3/71 11/83 500 <br />