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Pt-OT FLAN = <br /> (Draw To Scale) k <br /> SCALL T,. TO <br /> 1. Names of streets or roads nearest to or bounding the property- <br /> Outline of the property, giving dimensions and North direction. <br /> 3. Dimensioned outlines and locations of all existing and proposed structures, including covered areas such as patios, <br /> driveways and walks. <br /> 4.. Location of house sewer outlet, pubic sewer, sewage disposal system or proposed sewage cosposaj systern <br /> proposed expansion of sewage disposal system, or any other possible source of contamination. j <br /> 5' Location of other wells within radius of 150 feet on ,the property or adjoining property. <br /> 6. Location of sewage disposal system on adjoining property or within a radius of 150 feet. <br /> - I <br /> TF- <br /> I C.- OT <br /> Y L -.V <br /> I <br /> 121 <br /> 4L <br /> f <br />' I <br /> fe j I j <br /> 110 <br /> s <br /> PA <br /> J. <br /> VU "Ll <br /> i ✓t2 r'7 f� ` r � •c% <br /> I / h <br /> I _ <br /> L <br /> r <br /> i <br /> —• 4 <br /> a 7 a. L 1� l �,. � 3 + •+.s � <br /> 1 <br /> 1 l E <br /> — v W <br />