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T AIM TTCT+' VP1DnQrP <br /> arcu.a. <br /> a <br /> t <br /> To Be completed and Submitted by <br /> Date,/Issued <br /> ADDRESS UPA - <br /> APPLICANT'S NAME ,f v ADDRESS <br /> PROPOSED USE/CHANGE <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) Public Sewerage (name) <br /> SUMMARY OR COMMENTS: <br /> 1. VIA1 <br /> 3 <br /> On basis of above, I recommend: Approval Denial -Continuance <br /> Signed <br /> FOR OFFICE USE ONLY <br /> Report to Planning Standard Paragraph Approval 0Disapproval Continuance Q <br /> 6 c5LO <br /> HH o6 o6 3/71 <br />