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SEWAGE <br /> Distance to Public Sewers Connection necessary: Yes No— <br /> Does existing septic system comply with Ord. #1549 : Yes No_.,,, <br /> Unknown If no, explain: <br /> Describe septic installation to 'be installed: <br /> IlE'�O '�7� <br /> 2. HATEH 7P sC 0q r7 <br /> � I <br /> Is wa supplied by private well - es No Is Drell proper: <br /> Yes No c one <br /> Does existing or porposed use make this well public Water: Yes <br /> No Sample of well water taken: Yes No Date taken <br /> Results Additional information or comments <br /> 3 . <br /> Licensed scavenger pick-up: Yes No Service Area No. <br /> Other proposed disposal method: <br /> Potential problem: <br /> 4. ELY. MOSQ,[JITO OR YMQTOR PUrEiNTIAL <br /> State possible vector otentiftl & necessary control: <br /> 5. TQTT,ET/BATH FACILITES <br /> No. & location existing: Additional <br /> facilities needed <br /> 6. EnEVIOnS OpsRATION HISTORx <br /> 7 . UENERAL SANITATION <br /> State any problems not previously noted:= 1 <br /> I <br /> 8 . PQP(MATIOt DENSITY <br /> Appx. No . People per aq. mi. <br /> 6 <br />