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7SEWAGF <br /> f� <br /> i <br /> Distance to Public Sewers Connection necessary: Yes Nox <br /> Does existing 'septic system comply with Ord. 41549 : Yes-K— No-,,.., <br /> Unknown If no, explain: <br /> Describe septic installation to 'be installed: <br /> 2 . WATER SUPPLY <br /> Is w r supplied by private well : Yes ,�. No Is well proper: <br /> Yes eNo State deficiency: <br /> Does xi ting or porposed use make this well pu lic water: Yes <br /> No Sample of well water taken: Yes NoT Date taken <br /> Resu is Additional information or comments <br /> 3 . "AGE & REFUSE <br /> Lic\tl <br /> avenger pick-up: Yes No Service Are No. <br /> Othsed disposal method: <br /> Potroble,r,: <br /> 4. j:^TC,R PC,`fj;NTIAL <br /> State possi e vector potentiftl & necessar control: <br /> 5 . T_n 1 r ' <br /> No. & locution existin Additional <br /> facilities needed <br /> 8. PRE1102 ORERATIQU HIS 0 <br /> 7 . GENERAL T " <br /> State any pro•b 01, <br /> s not previously note <br /> 8 . r, ULATTO nENSTIX <br /> Appx. No. People per ..aq. rii . <br />