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N PI &PSI CY, <br /> 2. Cc t I in i I A, KY, P— W U112CUM , <br /> 3 . Dimenvwn& v ; and in, ni i10 proposed scrucoures, including <br /> Covecda RKWO 'Milos , <br /> 4or propcsed sewage <br /> . Location W Ususo 12,cl Gnk"� , !w0l " "Oev <br /> disposal aystem pTonos"d M019" Ot nnwagc diaposal system, or any other possible <br /> source of contaAl Aavilnl, <br /> 5, location A athar unjin ovuhm zanion of 75 feuE on Eta prope.--rt-,,, or- -Adng property. <br /> 6. Locatica of sawage disponal sy&Mw Oq adjOlning POOPOM or witivtn a radius of 100 feec. <br /> 4-4-7- <br /> .......... ...... <br /> ........... <br /> T A <br /> .......... .. . ................. ...... ................ <br /> ............... <br /> .......... <br /> ................ <br /> .. .. ...... <br /> . ............ . ...... ....... ...... ...... <br /> .......... <br />