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` To Be completed and Submitted by <br /> Date Issued <br /> ADDRESS U PA 92 73 J �A <br /> APPLICANT'S NAME <br /> �� ADDRESS <br /> PROPOSM USE/CHA.NGE <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 complgte -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 (naive) Public Sewerage (name) <br /> SUMMARY OR 00MMENTS: <br /> 1. - <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 Paragraph Approval Disapproval Continuance Q <br /> Y <br /> 1 2 <br /> Eli 06 06 3/71 <br />