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T AMT) TIQL' i>(l:>T <br /> AFP # <br /> To Be completed and Submitted by <br /> Date Issued <br /> ADDRESS U?A <br /> APP LICA2v T I SNAME ADDRESS <br /> PROPOSED USE/CHAP+G§nd <br /> i <br /> In completing the 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 /> 2. <br /> 3. <br /> On basis of above, I recommend: Approval Denial Continuance <br /> Signed <br /> FUR OFFICE USE ONLY <br /> Report to Planning Standard Paragraph Approval Disapproval Continuance a <br /> D <br /> C� <br /> EH 06 06 3/71 <br />