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i SEWAGE F <br /> . Distance to Public Sewers Connection necessary: Yes No_ <br /> Does existing septic system comply with Ord. ##549 : Yes No— <br /> Unknown It no, explain: <br /> Describe septic installation to 'be installed: <br /> 2. WATERSU?PLY <br /> Is water supplied- by private well : Yes iso Is well proper: <br /> Yes No State defi.ciency: <br /> i <br /> Does existing or porposed use make this well public water: Yes <br /> No Sample of well water taken: Yes No Date taken i <br /> Results Additional information or comments <br /> 3 . GARBAGE AREECTSF� <br /> Licensed scavenger pick-up: Yes— No— Service Area No. <br /> Other proposed disposal method: <br /> Potential problem:` <br /> 4. ELY. M05011a t2R MOTOR 22METIAL <br /> State possible vector potentiftl & necessary control: <br /> 5 . TOTLETZBATH FACTLITES <br /> No. & location existing: Additional <br /> Facilities needed._ _ -• <br /> 6. 0R r,,REJRAjjQLJ HISIORX <br /> 7. S'ENERAIi,.BANITATTON <br /> State any problems not previously noted: <br /> i <br /> 5 . EQPULATTQH D MaTTv <br /> Apex, No. People per eq. mi . <br /> r <br /> f <br />