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(Draw To Scilfl <br /> 1/ I <br /> f SCALE ../—i---tt rp C) <br /> 1. Names or streets or roads neasc,_. to or bouid,ng tr,r properly <br /> giving Dutbn�n} tt:e properly. 9 9 dimensions ants Tarin d,rection. <br /> 3. Dimensioned outlines and locations of all existiny and proposed structures,including covered areas su,;h as patty,. <br /> driveways and walks. <br /> 4. Location of house sewer outlet, ptib.:c sewer, sewage dssposal system or proposed sewage disposal system <br /> proposed expansion of sewage disposal system, or any other possible sourrc of contamination. <br /> S. Location of other wells within radius of 750 feet on the property or adlornsng property. <br /> 5. Location of sewage disposal system on ad',otning property or wiln,n a radius of 150 !t-et dr <br /> 30 � <br /> 7 <br /> r ; yFF I <br /> r 3o .00 <br /> . <br /> I01 <br /> 14. <br /> ! I J s}TC- <br /> AF <br /> P, <br /> 171 <br /> +P <br /> a <br /> iI <br /> t <br /> A <br /> i <br />