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� e MAU S +i <br /> Distance to Public Sewers Connection necessary: Yes No-!!� <br /> Does exis�g septic system comply with Ord. #549 : Yes_ No_„ <br /> UnkJ�./�ry{��awnn� If no, explain: L <br /> J�--e.SC CY.�-s��_ — i..z(C <br /> Describe septic installation to 'be installed: <br /> a <br /> 2. HATER SUPPLY <br /> Is Water supplied. by private Well : Yes -'�No Is well proper: <br /> Yes "-'�o State deficiency: <br /> Does existing or porposed use make this well puic water: Yes <br /> No ✓ Sample of well water taken: Yes No Late taken <br /> Results Additional information or comments <br /> 3 . GARBAGE & REFUSE . .. <br /> Licensed scavenger pick-up: Yes No Service Area No. <br /> Other proposed dispo 1 method: <br /> Potential problem: <br /> 4 . ELY, MOSQUITO OR V n 0R ' <br /> State possible vector potllntial & necas ry control: <br /> 5 . TOILET/BATH-FACILITES <br /> No. & location existing: Additional <br /> facilities needed <br /> 6. PRRYLa OPR .AT?Dully TORY <br /> 7. GENERAL 5ANITATIQU, <br /> State any problems not pr rlously noted: <br /> $ . EUQLATION J2EUST11 <br /> Appx. No. People per oq. mi. <br />