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` 1114D USE RLPOHT <br /> AFP # <br /> To Be completed and Submitted by <br /> Date Issued <br /> r <br /> ADDRESS UrA e ze <br /> APPLICANT'S TdAME ADDRESS _S'iOD �- 9 9 <br /> PROPOSL:D USE/CHAP+GE ��`L /1: /��'` fj,�0�. <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. <br /> Size of Parcel Requirements sq. ft. <br /> Public Water (name) Public Sewerage (name) <br /> SUMMARY OR COMMENTS: <br /> 2. <br /> 3• <br /> 4. <br /> On basis of above, I recommend: Approval Denial Continuance <br /> Signed , ��-�---- <br /> FOR OFFICE USE ONLY <br /> Report to Planning Standard Paragraptr Approval Disapproval Continuance Q <br /> � _.. <br /> EH o6 o6 3/71 <br /> i <br />