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SEWAGE <br /> Distance to Public Sewers Connection necessary: Yes No— <br /> Does existing , septic system comply with Ord. #549 : Yes No— <br /> Unknown—' U <br /> o_Unknown ' If no, explain: <br /> Describe septic installation to 'be installed. <br /> _ 2• WATER _SUpPU <br /> Is Water supplied- by private Drell: Yes `� Na Is well proper: <br /> Yes No State deficiency: <br /> Does existing or porposed use m6ke this well public water: Yes--,—/ <br /> No Sample of well water taken: Yes Na Date taken <br /> Results Additional information or comments <br /> 3 . GARBAGE & REFUSE <br /> 'No, Service Area No. <br /> Licensed scavenger ick�i� Yes <br /> t3 r P P <br /> Other proposed disposal method: <br /> Potential problem: <br /> 4. FLY, MOSOUTTQ OR V O13 E!Q-rENjTAL <br /> State possible vector potential & necessary control: <br /> 5, <br /> No. & location existing: ` ' Additional <br /> facilities needed <br /> 6. PRFyjQnS OPR„RATION HISTORY <br /> r,,-�-- <br /> 7. GENERAL SANITATION <br /> State any problems not previously noted: <br /> Is . POPULATION UENSTTY <br /> Appx. No. People per sq. Mi._ <br />