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�. 1\ itc:. '�WI.n.!T <br /> All' <br /> To Be completed and Submitted by <br /> Date Issued <br /> AT)DRESS UYA G J ) � L� <br /> APPLICANT'S NAME ADDRESS <br /> PROPOSE USE/CWiGE <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) �1 -�' Public Sewerage (name) nkr?­) <br /> SUMMARY OR COMMENTS: car f C�.t- <'l �� °F� �}-G y Q "oG' ct'i <br /> a , <br /> }4- ? 3` '� <br /> On basis of above, I recommend: Approval D/enialJ Continuance <br /> Signed r► �/ t1" ��2 .� /4`�' ' 7 <br /> FUR OFFICE USE ONLY <br /> Report to Planning Standard Paragraph Approval 0 Disapproval Continuance a <br /> 17� 1)"41W r Ali�M �/' ��" !�- /J <br /> O 14i o <br /> JA <br /> Eli 06 06 3/71 <br />