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V <br /> i . SEWAGE <br /> Distance to Public Sewers Connection necessary: Yes No <br /> Doss existing septic system comply with Ord . #548 : Yeses No— <br /> Unknown If no, explain: <br /> Descre septic installation to be installed: <br /> 5e &.J <br /> 2 . <br /> Is w ter supplied by private well : Yes No Is well proper: <br /> ye No State deficiency : <br /> Does 9xisting or porposed use make this well public water: Yes _k <br /> NoSa.mple of well water taken: Yes No Date taken <br /> Results Additional information or comments <br /> vvw L uj ems-. d .- CC) r P\a 67 � ripnr` [c�� <br /> 3 . GARBAGE <br /> Licensed scavenger pick-up: Yes No Service Area No. <br /> Other propomZd disposal method: <br /> Potential Problem: <br /> ti <br /> 4. FLY ,- MOSQUITQ QR <br /> State possible vebta potent otentZ & necessary control- <br /> State <br /> i <br /> 6 . <br /> No. & location existing: _ _ Additional <br /> facilities needed__.^J_ <br /> 6 . <br /> 7 . GFNB <br /> State any pro'ble.ms not previously gated: � _ <br /> S P�i3�(T3.A'�ZON DF I ITY <br /> Appx. No. People Per sq- mi. <br />