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PLOT <br />LO �' <br />(Draw UkCl. ) <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 ail existing and proposed structures, including covered areas such as patios, <br />driveways and walks. <br />4. Location of house sewer outlet, public sewer, sewage disposal system or.,proposed. sewage disposal system, <br />proposed expansion of sewage disposal system, or any other possible source of c-ohtamination. <br />5. Location of other wells within radius of -75 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 />I <br />f <br />N <br />I <br />I <br />I <br />i <br />� <br />�V <br />i <br />TI <br />- <br />I <br />r 0. <br />i <br />} <br />i <br />� <br />I <br />R <br />� <br />i <br />r,- <br />