Laserfiche WebLink
I ` F <br /> 1. SEWAGE r / <br /> Distance to Public Sewers 1 A Connection necessary: Yes No <br /> Does existing septic system comply with Ord. #549: Yes No <br /> (7"t�?I2— torr fo - <br /> Describe septic installation to be installed: —�dvX-2.- <br /> 2. 'WATER SUPPLY <br /> Is water ;;applied by private well: Yes ___-No Is well proper: Yes No <br /> State deficiency: <br /> Does existing or proposed use rr}ake this well public ater: Yes No Sample of well <br /> water taken: Yes No ✓ Date taken i4 Results- <br /> Additional information or comments: X.,r.' 4V <br /> �,�. Utc•_. arvS� out-`ftp D� S�..ol�'�e <br /> 3. GARBAGE & REFUSE ®® <br /> Licensed scavenger pick-up: Yes No Service Area No. <br /> Other proposed disposal method.-- <br /> Potential <br /> ethod:Potential problems: <br /> 4. FLY,-MOSQUITO, OR VECTOR POTENTIAL <br /> State possible vector potential & necessary control: <br /> 5. TOILET/BATH FACILITIES <br /> No. & location existing: <br /> Additional facilities needed <br /> 6. PREVIOUS OPERATION HISTORY <br /> 7. GENERAL SANITATION <br /> State any problems not previously noted: <br /> 8. POPULATION DENSITY <br /> I <br /> Appx. number of people per square mile <br />