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SRWgGF <br /> Distance to Public Sewers Connection necessary: Yes..--,No 4 <br /> Does existing septic system comply with Ord, #549 : Yes No_ <br /> Unknown If no, explain: <br /> Describe septic installation to 'be in tailed: v� <br /> i <br /> F 2. WATER SUPPLY <br /> Is Nater supplied- by private well : Yes No Is well proper: <br /> Yes No State deficiency : <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• .&._.IIEF�iS� - { <br /> Lic sed- scavenger pick-up: Yes No Service Area. No. ' <br /> athe proposed disposal method: <br /> Potent ml problem: <br /> 4 . S �POTE �m_rnL <br /> State pass ble vector potentif,l g� necessary co rol: <br /> 5. TQ r <br /> No. & location exi ting: Additional <br /> facilities needed <br /> 6. ERFVTQQ8 QtERATION HIS <br /> T ry <br /> State any prob , ms not previously noted: <br /> .t <br /> a <br /> 5 . POPU _J­"tusTTv t <br /> Appx No. People per sq. •mi. <br /> y <br /> ti • ( <br />