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W\I.L. UJI', Illi IUI\l <br /> APP # CQy <br /> To Be completed and Submitted by 7j 2 i 4`( <br /> Date Issued <br /> ADDRESS UFA :�50 6 Z L , �u 16' I c f <br /> APPLICANT'S NA14L ADDRESS <br /> PROPOSED USE/CHANGE- <br /> In <br /> SE/CHANGEIn completing the Lard 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 00MMENTS: e"vee/ ,, de <br /> 2. - <br /> 3. <br /> On basis of above, I recolmnend: Approval JTe al Continuance <br /> Signed <br /> FUR OFFICE USE ONLY <br /> Report to Planning Standard Paragraph Approval disapproval Continuance, a <br /> l <br /> Ei1 06 06 3/71 11/83 500 <br />