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L . SEWAGE <br /> Distance to Public Sewers NIA Connection necessary : Yes_ No`% <br /> Does existing septic system comply with Ord . #549 : Yes— No_ <br /> Unknown If no, explain: <br /> Ac- JZ 4f <br /> Describe septic installation to 'be installed: <br /> n i ,,,o o 47 1 <br /> 2 . WAT ,R SUPP .'I <br /> Is water supplied by private well : Yes _ NO–:L Is well proper: <br /> Yes_ No_ State deficiency: <br /> Does�isting or porposed use make this we' 1 public water: Yes <br /> No Sample of well water taken: Yes_ No✓Date taken <br /> Results Additional information or comments <br /> f <br /> 3 . GARBAGE & REFUSE <br /> Licensed scavenger pick-up: Yes_ No_ Service Area No . <br /> Other propose disposal method: <br /> Potential prob m: <br /> 4 . FLY , M 9QnTTn nR RQTOR L <br /> State possible ve for potential & ecessary control: <br /> 5 . TOILFT/BATH FACILITES <br /> No . & location existing: Additional <br /> facilities needed <br /> 6 . PRRVTOnS nPERATTON HTSTQ <br /> 7 . GENERAL SARI"PION <br /> State any problems not previously noted: <br /> 8 . POPULATION DR�JSTTY <br /> Appx. No . People per eq. mi . <br />