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av- <br /> To Be completed and Submitted by <br /> Date Issued <br /> ADDRESS UFA <br /> APPLICANT'S NAME AD <br /> PROPOSED USE/CIW;GE <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, wird 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 OOKMENTS: ' <br /> 2. <br /> 4. <br /> On basis of above, I recommend: Approval j Denial Continuance <br /> Signed <br /> FOR OFFICE USE ONLY <br /> Report to Planning Standard Paragraph Approval Disapproval Continuance a <br /> L IT1 c9 <br /> Y <br /> Ell 06 06 3/71 <br />