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(DRAW TO SCALE) <br /> SCALE 'r TO <br /> 5 <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 /> g and proposed structures, including <br /> 3. Dimensioned outlines and locations of all existin <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. ° <br /> 5. Location of other wells within radius of 75 feet on property or adjoining property. <br /> b, ga4lan'�,C�wage disposal system on adjoining property or within a radius of 100 feet. <br /> b <br /> i <br /> : _ ... <br /> . " — <br /> } ... .... <br /> ... <br /> .._. ... ._. <br /> : <br /> r� <br /> ; <br /> 1 . <br /> • <br /> r <br /> -. _ ... ... .._ .... _ _.. .._ <br /> _ .. ... <br /> ... .. <br /> 1 ... .......... <br /> ... <br /> -. .. ... <br /> . .. .. ._.. _.. n. -.. - -.. ... .-.e - 1. 7 _ - ... -_ - <br /> _ <br /> f.. <br /> . ... ... ... ... i .. .. _ .._ .... + <br /> ,z <br /> i4 ....... ..... ...- ---------- ..._ <br /> : <br /> _. .... .... .. <br /> .r <br /> . <br /> w <br /> : <br /> i <br /> µ <br /> r <br /> , <br /> : <br /> . 1 <br /> _ .. ... ! <br /> vc <br /> «n <br /> n {'� <br /> } <br /> 4 <br /> y � <br /> f_ <br /> ; <br />