Laserfiche WebLink
n qCc <br /> 1 . <br /> SEWAGE <br /> Distance to Public Sewers Connection necessary : Yes_ Nom <br /> Does existing septic system comply with Ord. #549 : Yes_ No_ <br /> Unknown ✓ If no, explain: <br /> Describe septic installation to be installed: <br /> 2. WATER SUPPLY <br /> Is watyr supplied by private well : Yes �2Io_ Is well proper: <br /> Yes_/L No_ State deficiency: <br /> Does a ting or porposed use make this well public water: 'Ies <br /> No Sample of well water taken: Yes_ Not/_ Date taken <br /> Results Additional information or comments <br /> 3 . GARBAGE & REFUSE ? y E..`re <br /> e7 t $ ✓✓ig�x.�T1,�'�'S <br /> Licensed scavenger pick-up: Yes.,..-No_ Service Area <br /> Other proposed disposal meted"' <br /> Potential problem: <br /> 4 . FLY. MOSOUTTO OR VE^TOR POTEWTAL <br /> State possible vector potential & necessary control: <br /> 5 . TOILET/BATH FACILJ TES <br /> No . & location existing: Additional <br /> facilities needed <br /> 6. PREVIOUS OPERATION HIS <br /> TORY <br /> 7 . GENERAL SANTT TTON <br /> State any problems not Previously noted : <br /> 6 . POPULATTON DENSITY <br /> Appx, No . People per sq . mi . ------ <br />