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<br /> (DRAW•TO SCALE)
<br /> :,SCALE: "_ATO
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<br /> 1. Names of streets or roads nearest, to or :bounding the property.
<br /> 2. Outline 'of the property, giving-dimensions--and North direction.
<br /> 3. Dimensioned outlines and locatibiis: of all existing and proposed structures_., including
<br /> covered areas such asapatios, drivewaysTand walks. 4
<br /> A. Location of house sewer outlet, public sewer, sewage disposal: system, or proposed sewage
<br /> disposal., system, ,proposed expansion ofe
<br /> swage disposal system;; 'or,any other possible,= S
<br /> source of contamination.:-�, �; „ `.sY►
<br /> 5. Location` of other wells within radius of 75 feet on the property or adjoining property.
<br /> b., Location �of' sewage disposal system-oh adjoitUng property, WfEiiii.a radius;,W 100• feet.
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