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M <br /> t <br /> SEWAGR <br /> Distance to Public Sewarer, Connection necessary: Yes ,,, No `� <br /> Does existing saptic `system comply With Ord. #549 : Yes No, <br /> Unknown ✓✓ If no, explain: <br /> - <br /> Describe septic installation to 'be installed: <br /> 2. SUPPLY <br /> Is water gu,Pplicd. b_� priv�ita well : Yes ✓ No Is well proper: <br /> Yes No State deficiency:_ .-tf uvtseQ(�d T,. ._�t al�a ,�e��,.,t.T� -. <br /> care wed 6 5 � + N0 <br /> Does e:-,Xisting or porposed tee make this well publ c water: Yes <br /> No Sample of well water taken: Yee Noute taken <br /> Results_ <br /> Additional <br /> information or comments <br /> W(,[( cLe-S IL -f C.J S <br /> 1' <br /> 3 . GARBAGE & REFUSE A" _�7ru,,,,t-9- <br /> Licensed scavenger pick-up: Yes No Service Area No. <br /> Other proposed disposal method: <br /> Potential problem: <br /> 4. 08 ,Cn 0- , <br /> State possible vector potentiftl necessary control: <br /> 5. MULFT . n <br /> No. & location existing: wo PeS:+y6 -"__S r, eyfs� Additional <br /> facilities needed �► <br /> 6. PREVIOTIBo <br /> 7. <br /> State any problems not Previously noted: <br /> 8 . IQH ST v <br /> Appx. No. People per sq. mi. <br /> i <br />