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SEWAUTE <br /> Distance to Public Sewers Connection necessary: Yes No <br /> Does existing septic system comply with Ord. ##549 : Yes No_,_,_ <br /> Unknown If no, explain: M <br /> y j <br /> b l 1 1 <br /> Describe septic installation to 'be installed: <br /> 2. WATER 5UPET-1 <br /> Is Nates supplied- by private well : Yes iso Is well proper: <br /> Yes 1/No State deficiency : <br /> Does existing or porposed use make this well ptb is Water: Yes <br /> Nompl:e of well water taken: Yes No Date take <br /> Res*z8f-1 <br /> Additional information or comments <br /> 3 . �RBAGE .. RE S W e- I c.,i s-" <br /> Licensed scavenger pick-up: Yes No Service Area No. <br /> Other proposed disposal. methdd: <br /> Potential. problem: <br /> 4. �-,—go <br /> S'tatd possible,vec of r p—OTT f ,c am= <br /> 5' oaf 'd?4 7-6 z a /° V�.u•e <br /> 5 . T�Q.LET/BATH FACILITES W��e.t.d h-,,> rC <br /> Additional <br /> No. & location exiting: <br /> facilities needed <br /> S. PRrkyT0a5UEkRATI0N HISIQRY <br /> 14 <br /> 7. #GzE2RATLjSAHjJAjT0H <br /> State any problems not previousl noted: <br /> 9 . BUMAID214 12ENSIT-Y, <br /> APpx. No . People per .sq. mi. <br />