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PLOT <br /> (Draw . <br /> • <br /> 1 Name of s �4ts or roads nearest to or bounding the property. <br /> 2, Outline of the property, giving dimensions and North directi on. <br /> Dimensioned o - • locationsof allexistingdproposed • s covered areas such as patios, <br /> driveways • <br /> Location of •use sewer outlet, public sewer, . s- disposal system or proposed .• ' disposal <br /> proposed - s. . of ..- disposalor other possible source of • • <br /> Location of other wells within radiusof 1 feet on - property or adjoin.11ng property. <br /> a of . •- disposal systefm on'aidjbining property or .r of'150 feet. <br /> MEN <br /> ■■■■■■■!��■■■■■■■■■■■■■■®■■■ ■■■ <br /> ■ ■■■■■eye■■ � ■■■■■■■■■■■■■■■�■■ <br /> I■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ <br /> MMOMMOMMEMOMMEM.MEMEMERIMMINER■■■ <br /> ■■EMME■■■■■■■ ■■■■■■■■M■■■M■■■■ <br />