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SHWAGR <br /> Distance to Public Sewers Connection necessary: Yes No_ <br /> Does existing septic system comply with Ord. #549 : Yes No_, <br /> Unknown If no, explain: <br /> ti� a cC �2 A,11 S� <br /> l <br /> Desc ibe septic it to 'be insta led: <br /> 2. WATER SUPPLY <br /> Is water supplied by private we'll : Yes ilo Is well proper: <br /> Yes No State defi/ lency: <br /> f— ,) cyW C41a`7 �'��ij <br /> Does existing or porposed/usc malcc this well public Water: Yes <br /> No-4— Semple of well water taken: Yes No Date taken <br /> Results Additional information op q mments <br /> +,P- <br /> 3 . GARBAGE & REFUSE <br /> Licensed scavenger pick-up: Yes No Service Area No. <br /> Other proposed disposa method. <br /> Potential problem:_ <br /> 4 . FLIL MOSQUITO O$ VZ^.TMJ ECi'r 1HZ11AL <br /> State possible vector potentiftl & necessco trol: <br /> y <br /> 5 . TO .T/ Ami_FACILITES <br /> No. & location existiis: — Additional <br /> facilities neededA= _ <br /> 6 . PREV1002 OPERATION HISTORY <br /> 7 . GENERAL SAITI'r,aT ON <br /> State any pr lems /not previously noted:_ <br /> A ,T� <br /> 8 . P�,13.�}r'U ALT I O14 ,DE 1 <br /> Appx. No. People per sq. mi . <br />