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000,� <br /> SEWAGF,." <br /> Distance to Public Sewers Connection necessary: Yes No— <br /> Does existing septic system comply with Ord . 0549 : Yes No_ <br /> Unknown If no, explain: <br /> Describe septic installation to.'be installed: <br /> 2. s 3 �• <br /> W,A,TER IMPLY <br /> Is water supplied- by private well: Yes Na Is well proper: <br /> Yee No State deficiency: <br /> Does existing or porpoeed 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, GARBAGE & REFUSEr <br /> Licensed scavenger pick-up: Yes No Service Area No. <br /> i <br /> Other proposed disposal method: <br /> Potential problem: <br /> 4. F r^Tort Pc►j'.1�NTI,p ,t <br /> State possible vector potentiftl ?A necessary control: <br /> 5. TQILET/BAILFACILITE-5 <br /> No. ek location existing: _ Additional <br /> facilities needed <br /> 6. TTr '^ <br /> 7 . GENERAL <br /> - - 4 <br /> a T <br /> State any problems not pilevioualy noted: � <br /> S . O ' v I. <br /> Apex.. No. People per ..act, mi. �"-- <br /> t <br /> f <br />