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(Draw To'Scaie) <br /> ` SCALE �-".TO .s , <br /> I. 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 /> 4. Location of house sewer outlet, public sewer, sewage disposal system or proposed sewage,d sposal'system, <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 o adjointii,ng prbperty�\ \,a <br /> 6. Location-of-seWage disposal system on adjoining property or within a radius„of 150 feet. <br /> \ Z,sky— Vt_.:V V�.....,� <br /> 1 \sel ` <br /> TT <br /> fit <br /> tj_ <br /> � t <br /> s e <br /> i i t <br /> . I <br /> I i � <br /> - r <br />