Laserfiche WebLink
�. . ,.1 SEWAGE <br /> Distance to Public" Sewers Connection necessary: Yes____ No <br /> Does existing seP-tic system comply with Ord. #549 : Yeses No_ <br /> Unknown If no, explain: <br /> Describe septic installation to 'be installed: <br /> - - <br /> 2. NAME SUPPLY <br /> Is water supplied. by private well : Yes . i No Is well proper: <br /> Yes � No State deficiency: <br /> Does xisting 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 . <br /> Licensed scavenger pick-up: Yes �L No Service Area No.� <br /> Other proposed disposal method: <br /> w Potential problem:_ _-. ....... <br /> 4. MQT0R PQ- ENTTAL <br /> State possible vector potential & necessary control: <br /> 5. t,ILITES <br /> No. & location existing: Additional <br /> facilities needed <br /> 6. PREVTOU rom HISTORXI <br /> JAzad <br /> 7. UNPRAL <br /> State any problems not previously noted: <br /> 3 . fl .•T v <br /> APpx. -No. People per eq. mi. <br /> r <br />