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f <br /> PLOT PLACE <br /> (Draw To Scale) <br /> SCALE " TO _ <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 locations of all existing and proposed structures,including covered areas such as patios, <br /> driveways and walks. <br /> stem.disposal e dis s <br /> 4. Location of house sewer outlet, public sewer, sewage disposal system or proposed sewage p Y <br /> proposed expansion of sewage disposal system, or any other possible source of contamination. <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. t <br /> I � � <br /> I � t <br /> I <br /> { <br /> IJ I _ i I <br /> - <br /> -41 <br /> Is <br /> r <br /> I <br /> I <br /> .► <br /> E <br /> I � <br /> I <br /> —!. <br /> ' <br /> i <br /> � E <br />