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' LJ►lVU U5t', 1{1s1101{'1' <br /> —- -- , <br /> AFP 11 <br /> To Be <br /> completed and Submitted by <br /> Date Issued <br /> ADDRESS UPA _ �n a c_,�4 ('g;✓i ITV S A SL't(���rr,- �e ,�,• j ( cc.G�� <br /> APPLICANT'S NAME ADDRESS c� <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 supplios, 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. r Ro a- 9 <br /> 2. <br /> 3• ✓< /,�� ,r' /tet l ;.r f <br /> 11. <br /> On basis of above, I recommend:.. Approval Denial Continuance <br /> Signed � s <br /> MR OFFICE USE ONLY <br /> Report to Planning Standard Paragraph Approval Disapproval Continuance; <br /> qa- <br /> — <br /> aC- <br /> Lit 06 06 3f ` "^° 11/83 500 <br />