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w <br /> i . MAU <br /> Distance to Public Sewers Connection necessary: Yes No4�F- <br /> Does existing septic sYstem comply with Ord. 0549 : Yes No— <br /> Unknown If no, explain: <br /> Des ibe Be tic instar tat on to be, install <br /> e �: �� ✓�/ f' <br /> 2. WATER SUPPLY,0 1 ' 8 ell proper: <br /> Is water supplied by private well : Yes No <br /> Yes No,__ State deficiency: .��1/�� <br /> T <br /> Does existing or porposed use make this well public water : Yes <br /> NoSample of well water taken: Yes No Date taken- <br /> Res s Additional information or comments <br /> 3 . GARBAGE & -REFUSE <br /> . Licensed scavenger pick-up: Yes No Service Area No. <br /> Other proposed disposal method: <br /> Potential problem: _ <br /> 4. MLLL7�. MUITSS aniTC2R_Ps)`'TI TI AL ' <br /> State passible vector potential & necessary control: ���"� <br /> 5 . ETZDATH E r <br /> No. & locationexisting : Additional <br /> facilities needed {�p� <br /> 6 . n `y'n j <br /> 7 . GENE,$�L SArI'�A] N <br /> State any problems not previously mated: <br /> 8 . POPULAT_IQN DM= <br /> Appx. No. People per sq. rr,i ._/��•�• �°,��r/•�tc <br />