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SEWAGConnection necessary : Yes"No— <br /> Distance to Public Sewers-----L— <br /> Does existing septic system comply with Ord. ##549 : Yes No_ <br /> Unknown If no, explain: <br /> Describe septic insta�.lation to 'be inetalled: <br /> 'Y <br /> 2 . AT R allRFIX <br /> Is water supplied- b,7 private well : Yes 'rho Is well proper: <br /> Yes No State deficiency: <br /> Does existing or porposed use make this well public water: Yes— <br /> No Sample of well water taken: Yes No Late taken <br /> Results Additional information or comments <br /> 3 . <br /> Licensed scavenger pick-�up: Yes No_ Service Area No._.�...—. <br /> Other proposed disposal method:: <br /> Potentia: problem: <br /> 4 . 'r o , <br /> State possible vpct r potential SA 'necessary control: <br /> 5 . Tn L r F;' <br /> �. Additional <br /> No . & location existing: _. <br /> facilities r:eeded.-----.., <br /> 6 . PREYn c; m T f) <br /> 7 . GENERAL j5AtjjT ,, Q <br /> State anir problems not previotta l Y noted: <br /> App: . No. People per aq. <br /> mi . <br /> .may ..... .^5 <br /> ■ <br /> ........................,_................_ ............ <br /> y,. <br />