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PLOY AAN. <br /> -(DRAW T0 -'SCALE) <br /> M SCALE „ T9&Wl <br /> 1. Names of streets or roadsro,nearest to or bounding the property. <br /> 0.2. <br /> ' Outline of the property, giving dimensions. and North direction. , r;,�,,j <br /> 3. I3imeiisioned outlines and locations of all existing and proposed. structures, including <br /> covered areas such as patios, driveways and walks. <br /> 4. Location of house sewer outlet, public sewer,"'sewage disposal system 'or proposed sewage <br /> disposal system', proposed expansion of 'sewage disposal system, or, any other possible <br /> source of contamination. r '. <br /> 5. Location" o' f other wells --within radius ,of 75 feet, on the'a.property-or ad joining property. <br /> 6. 1o`cation''of"sewage disposal``system on aaJoining property or within-a"r5adius o€ 150 feet. <br /> 4 <br /> t <br /> Lf <br /> ,T <br /> _ ... M.. .. ... ..... . .... Derr- <br /> i ; - +44e'r1'i ., l�'.Y.'• ."�.�....... _"_�TSb- T.4,Ct,teem ww,e.-IYVYWW `` � ' " '- :. e <br /> Ito <br /> �1 <br /> ...... ......... <br /> Iq <br /> ..,.. t <br /> ' <br /> Pib, <br /> 'r 1 Y-m—�•• } ' rW.'r i . <br /> _..�-...-_ •.•. Y <br />